DR. LEO RYO OTAKE (NPI# 1770761025) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770761025 |
| Entity Type | Individual |
| Full Name | DR. LEO RYO OTAKE |
| Credential | M.D., PH.D, |
| Practice Address |
722 Post Rd Darien CT 06820 |
| Mailing Address |
722 Post Rd Darien CT 06820-4744 |
| Practice Telephone | 2036569999 |
| Mailing Telephone | 2036569999 |
| Enumeration Date | 2008-02-07 |
| Last Update Date | 2018-05-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208200000X | Plastic Surgery | 246657 | NY | Allopathic & Osteopathic Physicians |
| Y | 208200000X | Plastic Surgery | 046053 | CT | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | INDIVIDUAL MEDICARE PTAN | D400026606 | 01 |
| Street Address |
722 POST RD |
| City | DARIEN |
| State | CT |
| Zip Code | 06820 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649220369 | Anya Kishinevsky | Plastic Surgery | 722 Post Rd, Suite 200, Darien, CT 06820-4731 | 2006-05-11 |
| 1790276814 | Darien Plastic Surgery Associates Pllc | Plastic Surgery | 722 Post Rd, Darien, CT 06820-4744 | 2018-05-24 |
| 1154766343 | Aesthetic Surgery Center LLC | Clinic/Center | 722 Post Rd, Darien, CT 06820-4744 | 2013-05-02 |
| 1326304437 | L & E Anesthesia Services LLC | Nurse Anesthetist, Certified Registered | 722 Post Rd, Darien, CT 06820-4744 | 2012-04-03 |
| 1790974012 | The Healthy Child,l.l.c. | Pediatrics | 722 Post Rd, Darien, CT 06820-4731 | 2007-10-23 |
| 1205989571 | Fredric Newman | Plastic Surgery | 722 Post Rd, Darien, CT 06820-4731 | 2007-01-19 |
| 1891848065 | Fredric Newman Md LLC | Plastic Surgery | 722 Post Rd, Darien, CT 06820-4731 | 2007-01-19 |
| 1477606655 | David Passaretti | Plastic Surgery | 722 Post Rd, Darien, CT 06820-4731 | 2007-01-19 |
| 1609929884 | David Passaretti Md LLC | Plastic Surgery | 722 Post Rd, Darien, CT 06820-4731 | 2007-01-19 |
| 1861545063 | Darien Medical Arts LLC | Clinic/Center | 722 Post Rd, Darien, CT 06820-4731 | 2007-01-19 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225574445 | Resolution Wellness | Physical Therapist | 5 Tokeneke Rd, Darien, CT 06820 | 2017-01-11 |
| 1548619158 | Gurpreet Singh | Pharmacist | 964 Post Road, Darien, CT 06820 | 2016-06-06 |
| 1578830584 | Darien Pediatric Associates, LLC | Pediatrics | 106 Noroton Avenue, Darien, CT 06820 | 2011-11-18 |
| 1649574476 | Kelly Anne Wolfe | Physical Therapist | 319 Post Rd, Darien, CT 06820 | 2011-01-09 |
| 1932409612 | Suzanne T. Spinella-curto | Social Worker | 110 Post Road, Darien, CT 06820 | 2010-10-27 |
| 1568793644 | Alan Marc Muney | Pediatrics | 70 Leeuwarden Rd., Darien, CT 06820 | 2010-01-29 |
| 1134356959 | Yuen-jong Liu | Plastic Surgery | 722 Post Rd Ste 200, Darien, CT 06820 | 2009-06-18 |
| 1740431667 | Lisa Michelle Supino | Psychologist | 6 Thorndal Circle, Darien, CT 06820 | 2008-10-09 |
| 1326222522 | Sharon Ellen Kutner | Social Worker | Family Centers- Center for Hope, 590 Post Road, Darien, CT 06820 | 2007-12-24 |
| 1174719637 | Jeanne E Castellucci | Chiropractor | 747 Post Rd, Darien, CT 06820 | 2007-09-19 |
| Find all providers in zip 06820 | ||||
| Taxonomy Code | 208200000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Plastic Surgery |
| A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Plastic Surgery, 2007. http://www.abplsurg.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Plastic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275997975 | Peau | Plastic Surgery | 1472 Boston Post Rd, Darien, CT 06820-5909 | 2016-04-08 |
| 1134356959 | Yuen-jong Liu | Plastic Surgery | 722 Post Rd Ste 200, Darien, CT 06820 | 2009-06-18 |
| 1649220369 | Anya Kishinevsky | Plastic Surgery | 722 Post Rd, Suite 200, Darien, CT 06820-4731 | 2006-05-11 |
| 1790276814 | Darien Plastic Surgery Associates Pllc | Plastic Surgery | 722 Post Rd, Darien, CT 06820-4744 | 2018-05-24 |
| 1205989571 | Fredric Newman | Plastic Surgery | 722 Post Rd, Darien, CT 06820-4731 | 2007-01-19 |
| 1891848065 | Fredric Newman Md LLC | Plastic Surgery | 722 Post Rd, Darien, CT 06820-4731 | 2007-01-19 |
| 1477606655 | David Passaretti | Plastic Surgery | 722 Post Rd, Darien, CT 06820-4731 | 2007-01-19 |
| 1609929884 | David Passaretti Md LLC | Plastic Surgery | 722 Post Rd, Darien, CT 06820-4731 | 2007-01-19 |
| 1023053709 | Anya Kishinevsky Md LLC | Plastic Surgery | 722 Post Rd, Suite 200, Darien, CT 06820-4731 | 2006-06-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720642762 | Riverview Emergency Services LLC | Plastic Surgery | 148 East Ave Ste 3h, Norwalk, CT 06851-5726 | 2019-04-25 |
| 1073177184 | Laurel Chandler Md Pllc | Plastic Surgery | 195 Danbury Rd Ste 203, Wilton, CT 06897-4075 | 2019-04-24 |
| 1285080416 | Plastic Surgery Practice of Connecticut | Plastic Surgery | 44 Amogerone Crossway # 8151, Greenwich, CT 06830-9993 | 2016-05-06 |
| 1356684112 | Joseph Lopez | Plastic Surgery | 330 Cedar St Ste 330, New Haven, CT 06510-3218 | 2013-03-30 |
| 1881956514 | Mid State Md, LLC | Plastic Surgery | 85 Church St Ste 500, Middletown, CT 06457-3647 | 2012-06-08 |
| 1407018419 | Julia Marie Toto | Plastic Surgery | University Physicians, 263 Farmington Avenue, Farmington, CT 06030 | 2008-06-30 |
| 1376704353 | Christopher David Hughes | Plastic Surgery | 399 Farmington Ave Ste 210, Farmington, CT 06032-1944 | 2008-06-22 |
| 1659546323 | Richard Restifo, Md PC | Plastic Surgery | 200 S Orange Center Rd, Orange, CT 06477-3349 | 2008-04-24 |
| 1801919170 | Elsa M. Raskin Physician PC | Plastic Surgery | 2 1 2 Dearfield Drive, Suite 102, Greenwich, CT 06831 | 2007-04-09 |
| 1730210303 | Amir R Nasir | Plastic Surgery | 1 Morningside Dr N Bldg B, Westport, CT 06880-3850 | 2007-03-08 |
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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.