CLINIC 21 OF CONNECTICUT LLC (NPI# 1730580325) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730580325 |
| Entity Type | Organization |
| Organization Name | CLINIC 21 OF CONNECTICUT LLC |
| Practice Address |
497 Westport Ave Norwalk CT 06851-4411 |
| Mailing Address |
4535 Dressler Rd Nw Canton OH 44718-2545 |
| Practice Telephone | 2032764888 |
| Mailing Telephone | 3304934443 |
| Mailing Fax Number | 3304938677 |
| Enumeration Date | 2014-09-15 |
| Last Update Date | 2015-05-20 |
| 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 |
|---|---|---|---|---|
| 1760856306 | Clinic 21 of Connecticut LLC | Emergency Medicine | 2001 W Main St, #100, Stamford, CT 06902-4501 | 2015-11-19 |
| Street Address |
497 WESTPORT AVE |
| City | NORWALK |
| State | CT |
| Zip Code | 06851-4411 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619577574 | Katelyn Scott | Nurse Practitioner | 497 Westport Ave, Norwalk, CT 06851-4411 | 2020-10-29 |
| 1508312893 | Tejal Kothari Shaikh | Family Medicine | 497 Westport Ave, Norwalk, CT 06851-4411 | 2016-08-28 |
| 1629452719 | Paola Ninoska Cruz Chery | Internal Medicine | 497 Westport Ave, Norwalk, CT 06851 | 2015-07-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144763434 | Cynthia Eliezer | Student in an Organized Health Care Education/Training Program | 120 East Ave 2nd Flr., Norwalk, CT 06851 | 2016-11-18 |
| 1356897672 | Be Balanced Naturopathic Care Center, LLC | Naturopath | 91 East Ave, Garden Level, Norwalk, CT 06851 | 2016-08-28 |
| 1861843559 | Valerie Andree Vincent | Student in an Organized Health Care Education/Training Program | 120 East Avenue-2nd Floor, Catholic Charities, Norwalk, CT 06851 | 2016-06-24 |
| 1417333758 | Laura Rebecca Nierenberg Fishman | Marriage & Family Therapist | 161 East Avenue, Suite 101, Norwalk, CT 06851 | 2015-08-10 |
| 1487085411 | Danielle Christine Boland | Social Worker | 206 Wolfpit Avenue, Norwalk, CT 06851 | 2013-12-02 |
| 1427485846 | Michelle Clement | Technician/Technologist | 650 Main Avenue, Norwalk, CT 06851 | 2013-09-30 |
| 1932447430 | Rebecca Roessler Velasquez | Social Worker | 225 W Rocks Rd, Norwalk, CT 06851 | 2013-01-18 |
| 1275809154 | Tiffany A. Mccarty | Social Worker | 166 East Ave Ste 204, Norwalk, CT 06851 | 2012-03-26 |
| 1356573547 | Cheree Louise Fenske | Clinical Neuropsychologist | 761 Main Ave Ste 104, Norwalk, CT 06851 | 2009-08-20 |
| 1083869572 | Carol Lynne Cooper | Obstetrics & Gynecology | 17 North Ave., Norwalk, CT 06851 | 2008-11-25 |
| Find all providers in zip 06851 | ||||
| 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 |
|---|---|---|---|---|
| 1487017497 | Varun Shahi | Emergency Medicine | 12310 Del Rio Ct, Norwalk, CA 90650-8027 | 2016-03-29 |
| 1720321144 | Stephanie Hanna | Emergency Medicine | 47 Comstock Hill Ave, Norwalk, CT 06850-1003 | 2013-04-03 |
| 1992959076 | Claudia Lynn Beals | Emergency Medicine | 304 Main Ave, 209, Norwalk, CT 06851-6167 | 2008-11-16 |
| 1124178546 | Mark Harris | Emergency Medicine | Fisher-titus Medical Center, 272 Benedict Ave., Norwalk, OH 44857 | 2007-01-10 |
| 1154344620 | Steven Gary Berger | Emergency Medicine | 346 Main Ave, Norwalk, CT 06851-1510 | 2006-07-25 |
| 1942208723 | Michael Carius | Emergency Medicine | 34 Maple St, Norwalk, CT 06850-3815 | 2005-07-14 |
| 1386176832 | Danielle Roberts | Emergency Medicine | 34 Maple St, Norwalk, CT 06850-3894 | 2017-04-03 |
| 1912308446 | Coast Plaza Emergency Physicians Group Inc | Emergency Medicine | 13100 Studebaker Rd, Norwalk, CA 90650-2531 | 2014-09-16 |
| 1689089195 | Jung-eun Jane Lim | Emergency Medicine | 13100 Studebaker Rd, Norwalk, CA 90650-2531 | 2014-06-23 |
| 1316200785 | Richard J Teitell | Emergency Medicine | 24 Stevens St, Norwalk, CT 06850 | 2012-06-20 |
| Find all providers in NORWALK | ||||
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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.