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Organization
OPTIMAL WELLNESS OF WEST HARTFORD,LLC
Active
Organization
OPTIMAL WELLNESS OF WEST HARTFORD,LLC
Active
Other names
Medi-Weightloss Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
LUIZA F PETRE M.D. (OWNER)
(212) 553-2700
Entity
Organization
Contact information
Practice address
1001 FARMINGTON AVE, WEST HARTFORD, CT 06107-2135
(860) 213-8365
Mailing address
1001 FARMINGTON AVE, WEST HARTFORD, CT 06107-2135
(860) 213-8365
Taxonomy
Speciality
Code
Description
License number
State
207QB0002X
Obesity Medicine (Family Medicine) Physician
Primary
207Q00000X
CT
207RB0002X
Obesity Medicine (Internal Medicine) Physician
207R00000X
NULL
207RB0002X
Obesity Medicine (Internal Medicine) Physician
207R00000X
—
Other
Enumeration date
10/20/2015
Last updated
10/20/2015
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