Provider Demographics
NPI:1427596477
Name:THE CT WELLNESS INSTITUTE
Entity type:Organization
Organization Name:THE CT WELLNESS INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GINA
Authorized Official - Middle Name:M
Authorized Official - Last Name:CARUCCI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:860-257-8445
Mailing Address - Street 1:53 NEW BRITAIN AVE
Mailing Address - Street 2:
Mailing Address - City:ROCKY HILL
Mailing Address - State:CT
Mailing Address - Zip Code:06067-1175
Mailing Address - Country:US
Mailing Address - Phone:860-257-8445
Mailing Address - Fax:
Practice Address - Street 1:53 NEW BRITAIN AVE
Practice Address - Street 2:
Practice Address - City:ROCKY HILL
Practice Address - State:CT
Practice Address - Zip Code:06067-1175
Practice Address - Country:US
Practice Address - Phone:860-257-8445
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-09
Last Update Date:2017-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1130261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service