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
—
Other
Enumeration date
10/20/2015
Last updated
10/20/2015
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