CLINIC 21 OF CONNECTICUT LLC (NPI# 1760856306) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760856306 |
| Entity Type | Organization |
| Organization Name | CLINIC 21 OF CONNECTICUT LLC |
| Practice Address |
2001 W Main St #100 Stamford CT 06902-4501 |
| Mailing Address |
4535 Dressler Rd Nw Canton OH 44718-2545 |
| Practice Telephone | 2032768540 |
| Practice Fax Number | 2032768541 |
| Mailing Telephone | 3304934443 |
| Mailing Fax Number | 3304938677 |
| Enumeration Date | 2015-11-19 |
| Last Update Date | 2015-11-19 |
| Authorized Official Name | THOMAS J ZYNIEWICZ II (PRESIDENT) |
| Authorized Official Telephone | 3304934443 |
| Authorized Official Credential | DO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730580325 | Clinic 21 of Connecticut LLC | Emergency Medicine | 497 Westport Ave, Norwalk, CT 06851-4411 | 2014-09-15 |
| Street Address |
2001 W MAIN ST #100 |
| City | STAMFORD |
| State | CT |
| Zip Code | 06902-4501 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740275866 | Katherine Kelly Noble | Pediatrics | 2001 W Main St, Suite 132, Stamford, CT 06902-4501 | 2005-09-14 |
| 1073011870 | Matthew Mason | Physician Assistant | 2001 W Main St, Stamford, CT 06902-4501 | 2018-01-26 |
| 1255844197 | Philease J Martin | Physician Assistant | 2001 W Main St, Stamford, CT 06902-4501 | 2017-11-14 |
| 1548625569 | Sound Beach Pediatrics, LLC | Clinic/Center | 2001 W Main St, Suite 132, Stamford, CT 06902-4501 | 2015-12-17 |
| 1619346418 | Celebrating Children | Occupational Therapist | 2001 W Main St, Suite #135, Stamford, CT 06902-4501 | 2015-09-22 |
| 1316386428 | Munroetherapies & Consultation, P.C. | Community/Behavioral Health | 2001 W Main St, Stamford, CT 06902-4501 | 2013-06-21 |
| 1801231659 | Nordberg Plastic Surgery Center, LLC | Clinic/Center | 2001 W Main St, Suite 150, Stamford, CT 06902 | 2013-05-07 |
| 1285975417 | Beth O'donnell, Ph.d. LLC | Psychologist | 2001 W Main St, Suite 106g, Stamford, CT 06902-4501 | 2013-03-13 |
| 1598931057 | Louise Marie Anselmo | Physical Therapist | 2001 W Main St, Suite 132, Stamford, CT 06902-4501 | 2008-05-05 |
| 1043482128 | Leif O Nordberg Md, LLC | Clinic/Center | 2001 W Main St, Suite 155, Stamford, CT 06902 | 2008-03-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861043242 | Palak Bhambri | Pharmacist | 537 Canal Street, Stamford, CT 06902 | 2019-09-26 |
| 1730654815 | Brenice Duroseau | Nurse Practitioner | 292 Long Ridge Rd Ste 202, Stamford, CT 06902 | 2018-10-04 |
| 1447732862 | Ngoc Lam | Pharmacist | 1990 West Main Street, Stamford, CT 06902 | 2018-09-01 |
| 1336627264 | Margaret F Gorelick | Nurse Practitioner | Stamford Health, One Hospital Plaza, Stamford, CT 06902 | 2018-08-02 |
| 1174053425 | Ashley Marie Santana | Social Worker | 110 Commons Park N Apt 1158, Stamford, CT 06902 | 2017-06-19 |
| 1578090395 | Anas Al-sabbagh | Dentist | 1 Strawberry Hill Court Suite L7 Stamford, Connecticut, Stamford, CT 06902 | 2017-05-11 |
| 1154862936 | Hillary Rubin | Psychologist | 44 Commerce Avenue, Stamford, CT 06902 | 2017-03-14 |
| 1801332135 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 1 Hospital Plz Ste G122, Stamford, CT 06902 | 2017-01-10 |
| 1932563277 | Mary Hurtadodemendoza | Pharmacist | 59 Courtland Ave 2m, Stamford, CT 06902 | 2016-04-13 |
| 1235592247 | Advanced Therapy and Performance LLC | Physical Medicine & Rehabilitation | 75 Selleck Street, Stamford, CT 06902 | 2016-03-29 |
| Find all providers in zip 06902 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669512570 | Dorothy M Turnbull | Emergency Medicine | 30 Shelburne Rd At West Broad Street, Stamford, CT 06904 | 2007-02-08 |
| 1366527251 | Scott Raymond Martin | Emergency Medicine | 29 Hospital Plz Ste 502, Stamford, CT 06902-3602 | 2006-10-26 |
| 1508809161 | Maria Brea | Emergency Medicine | 30 Shelburne Road, Stamford, CT 06904 | 2006-06-13 |
| 1982139523 | Michael Francois | Emergency Medicine | 1 Hospital Plz, Stamford, CT 06902-3602 | 2017-04-20 |
| 1134563349 | Richard Katz | Emergency Medicine | 30 Shelburne Rd, Stamford, CT 06902-3628 | 2013-04-18 |
| 1427321892 | Tiphany Alexandrea Jolly | Emergency Medicine | 30 Shelburne Road, Stamford, CT 06902 | 2012-02-16 |
| 1093023434 | Sarah Marie Vitello | Emergency Medicine | 30 Shelburne Rd, Stamford, CT 06902-3628 | 2010-09-20 |
| 1790932234 | Amy Gandhi | Emergency Medicine | 30 Shelburne Rd, Stamford, CT 06902-3628 | 2008-08-27 |
| 1023213717 | Alexandr Rafailov | Emergency Medicine | 30 Shelburne Rd, Stamford, CT 06902-3628 | 2007-06-20 |
| 1689879082 | Jason Adam Fischel | Emergency Medicine | 30 Shelburne Rd, Stamford, CT 06902-3628 | 2007-06-18 |
| Find all providers in STAMFORD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.