Organization
OPTIMAL WELLNESS OF WEST HARTFORD
Active
Other names
Medi-Weightloss
Organization subpart
No
Provider details
NPI number
Authorized official
LUIZA PETRE MD (OWNER)
(917) 553-2700
Entity
Organization
Contact information
Practice address
1001 FARMINGTON AVE., WEST HARTFORD, CT 06107
(860) 213-8365
Mailing address
1001 FARMINGTON AVE., WEST HARTFORD, CT 06107
(860) 213-8365
Taxonomy
Speciality
Code
Description
License number
State
207QB0002X
Obesity Medicine (Family Medicine) Physician
052588
CT
207RB0002X
Obesity Medicine (Internal Medicine) Physician
Primary
052588
CT
Other
Enumeration date
10/29/2015
Last updated
10/29/2015
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