| Organization Name: | HOLISTIC FAMILY MEDICINE LLC |
| NPI Number: | 1114269032 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DOMENICK JOHN MASIELLO (OWNER) |
| Mailing Address: | 430 Old Sib Rd Ridgefield |
| State: | CT US |
| Postal Code: | 068772335 |
| Phone Number: | 2038263582 |
| Fax Number: | 8557982816 |
| NPI Enumeration Date: | 03/18/2013 |
| NPI Last Update Date: | 03/18/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 204D00000X |
| License Number: | 000278 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CT |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Neuromusculoskeletal Medicine & OMM |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |