Provider Type Icon

OPTIMUM MEDICAL LLC NPI 1720215346


NPI Information

NPI: 1720215346
Provider Name: OPTIMUM MEDICAL LLC
Classification: Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 07D2027167

Address:
205 MAIN ST
STE 1
DANBURY, CT
ZIP 06810
Phone: (203) 794-9000
Get Directions

OPTIMUM MEDICAL LLC is a pediatrics in Danbury, CT. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. OPTIMUM MEDICAL LLC NPI is 1720215346. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

205 MAIN ST
STE 1
DANBURY, CT
ZIP 06810-627
Phone: (203) 794-9000

The provider's authorized official is Jacques E Etienne .
The authorized official title is Physician/owner and has the following contact phone number (203) 775-7949.

The CLIA number assigned to this NPI record is 07D2027167 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/22/2009 and was last updated on 10/15/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208000000XPediatrics042829CONNECTICUTYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.