Organization
OPTIMUM MEDICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACQUES E ETIENNE M.D. (PHYSICIAN/OWNER)
(203) 775-7949
Entity
Organization
Contact information
Practice address
205 MAIN ST, STE 1, DANBURY, CT 06810-6627
(203) 794-9000
Mailing address
205 MAIN ST, STE 1, DANBURY, CT 06810-6627
(203) 794-9000
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
042829
CT
Other
Enumeration date
06/22/2009
Last updated
10/15/2013
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