Provider Demographics
NPI:1033939327
Name:FERNWOOD HOLISTIC HEALTH
Entity type:Organization
Organization Name:FERNWOOD HOLISTIC HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALQUEZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-961-8583
Mailing Address - Street 1:1921 BOSTON POST RD UNIT 2&3
Mailing Address - Street 2:
Mailing Address - City:WESTBROOK
Mailing Address - State:CT
Mailing Address - Zip Code:06498-2171
Mailing Address - Country:US
Mailing Address - Phone:860-661-5824
Mailing Address - Fax:860-661-5843
Practice Address - Street 1:1921 BOSTON POST RD
Practice Address - Street 2:
Practice Address - City:WESTBROOK
Practice Address - State:CT
Practice Address - Zip Code:06498-2171
Practice Address - Country:US
Practice Address - Phone:860-661-5824
Practice Address - Fax:860-661-5843
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-12
Last Update Date:2025-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No175F00000XOther Service ProvidersNaturopathGroup - Multi-Specialty