Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 000444 | CT |
N | 175L00000X | Homeopath | 000444 | CT |
NPI | 1669738084 |
---|---|
Provider Name | Golnar Raissi-Sadeghi |
First Address | Stamford, CT 06902-2594 |
Second Address | Stamford, CT 06902-2594 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2012 |
Last Update Date | 10/04/2012 |