Organization
HER WELLNESS HEALTH CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIKELOMO OTUYELU-GARRITANO MD (PHYSICIAN)
(914) 523-3469
Entity
Organization
Contact information
Practice address
65 OLD RIDGEFIELD RD, WILTON, CT 06897-3018
(203) 665-0900
(203) 665-0899
Mailing address
19 GROUND PINE RD, WILTON, CT 06897-1917
(914) 523-3469
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
047101
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004213865
—
CT
Enumeration date
07/20/2017
Last updated
07/21/2022
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