# NORTHEAST NATURAL MEDICINE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1588982912
- **Authorized official:** DR. SHAWN MORGAN CARNEY N.D. (OWNER PRESIDENT MANAGER)
- **Authorized official phone:** (800) 723-2962

## Contact information

- **Practice address:** 33 MAIN ST, SUITE 15, NEWTOWN, CT 06470-2129
- **Practice address phone:** (800) 723-2962
- **Practice address fax:** (800) 957-5421
- **Mailing address:** 107 EDGELAKE DR, SANDY HOOK, CT 06482-1140
- **Mailing address phone:** (203) 947-2412
- **Mailing address fax:** (800) 957-5421

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 175F00000X | Naturopath | 425 | CT | Yes |
| 225700000X | Massage Therapist | 004130 | CT | — |

## Other

- **Enumeration date:** 05/10/2010
- **Last updated:** 05/11/2010