Provider Demographics
NPI:1992271852
Name:BIONDI, VANESSA R (ND)
Entity type:Individual
Prefix:DR
First Name:VANESSA
Middle Name:R
Last Name:BIONDI
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:CT
Mailing Address - Zip Code:06010-5093
Mailing Address - Country:US
Mailing Address - Phone:860-681-1310
Mailing Address - Fax:
Practice Address - Street 1:122 MAPLE ST
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:CT
Practice Address - Zip Code:06010-5093
Practice Address - Country:US
Practice Address - Phone:860-681-1310
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-18
Last Update Date:2018-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT627175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath