Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 530 | CT |
NPI | 1033516869 |
---|---|
Provider Name | Tonya Pasternak |
First Address | East Hartford, CT 06108-3006 |
Second Address | Manchester, CT 06040-5251 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/11/2014 |
Last Update Date | 21/11/2014 |