Organization
HOLISTIC FAMILY MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DOMENICK JOHN MASIELLO DO (OWNER)
(203) 826-3582
Entity
Organization
Contact information
Practice address
430 OLD SIB RD, RIDGEFIELD, CT 06877-2335
(203) 826-3582
(855) 798-2816
Mailing address
430 OLD SIB RD, RIDGEFIELD, CT 06877-2335
(203) 826-3582
(855) 798-2816
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
000278
CT
207Q00000X
Family Medicine Physician
Primary
000278
CT
Other
Enumeration date
03/18/2013
Last updated
03/18/2013
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