# ELITE MEDICAL WELLNESS CENTER P.C.

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

## Provider details

- **NPI number:** 1316516495
- **Authorized official:** COURTNEY MURRAY (PROJECT MANAGER)
- **Authorized official phone:** (203) 858-3531

## Contact information

- **Practice address:** 106 NOROTON AVE, DARIEN, CT 06820-5237
- **Practice address phone:** (203) 202-7688
- **Mailing address:** 99 DUTCH HILL RD, ORANGEBURG, NY 10962-2185
- **Mailing address phone:** (203) 202-7688

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 133V00000X | Registered Dietitian | — | NULL | — |
| 133V00000X | Registered Dietitian | — | — | — |
| 133VN1201X | Obesity and Weight Management Nutrition Registered Dietitian | — | NULL | — |
| 133VN1201X | Obesity and Weight Management Nutrition Registered Dietitian | — | — | — |
| 207KA0200X | Allergy Physician | — | NULL | — |
| 207KA0200X | Allergy Physician | — | — | — |
| 207QA0000X | Adolescent Medicine (Family Medicine) Physician | — | NULL | — |
| 207QA0000X | Adolescent Medicine (Family Medicine) Physician | — | — | — |
| 207QA0505X | Adult Medicine Physician | — | NULL | — |
| 207QA0505X | Adult Medicine Physician | — | — | — |
| 207QB0002X | Obesity Medicine (Family Medicine) Physician | — | NULL | Yes |
| 207QB0002X | Obesity Medicine (Family Medicine) Physician | — | — | Yes |
| 207QS0010X | Sports Medicine (Family Medicine) Physician | — | NULL | — |
| 207QS0010X | Sports Medicine (Family Medicine) Physician | — | — | — |
| 207QS1201X | Sleep Medicine (Family Medicine) Physician | — | NULL | — |
| 207QS1201X | Sleep Medicine (Family Medicine) Physician | — | — | — |
| 207W00000X | Ophthalmology Physician | — | NULL | — |
| 207W00000X | Ophthalmology Physician | — | — | — |
| 207WX0200X | Ophthalmic Plastic and Reconstructive Surgery Physician | — | NULL | — |
| 207WX0200X | Ophthalmic Plastic and Reconstructive Surgery Physician | — | — | — |

## Other

- **Enumeration date:** 06/22/2021
- **Last updated:** 12/21/2023