1326469024 NPI number — SUGATI HEALTH AND WELLNESS

Table of content: MARGARET ELIZABETH BADER FNP (NPI 1710330212)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326469024 NPI number — SUGATI HEALTH AND WELLNESS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SUGATI HEALTH AND WELLNESS
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1326469024
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/23/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
37 W TOWN ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LEBANON
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06249-1536
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
860-281-7489
Provider Business Mailing Address Fax Number:
860-642-4740

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
37 W TOWN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LEBANON
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06249-1536
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
860-281-7489
Provider Business Practice Location Address Fax Number:
860-642-4740
Provider Enumeration Date:
12/23/2013

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
RITZ
Authorized Official First Name:
JONATHAN
Authorized Official Middle Name:
ROBERT
Authorized Official Title or Position:
NATUROPATHIC PHYSICIAN
Authorized Official Telephone Number:
860-281-7489

Provider Taxonomy Codes

  • Taxonomy code: 261QH0100X , with the licence number:  CT00482 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)