Pomperaug Plastic Surgery, LLC

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

POMPERAUG PLASTIC SURGERY, LLC

Practice address

22 Poverty Road
Southbury, CT 06488

Phone

(203) 262-6200

Fax

(203) 262-6205

NPI assigned

Nov 2, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Seung-Yeun Waitze, M.D.NPI 1437114071

Title

Owner

Phone

(203) 262-6200

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Seung-Yeun Waitze, M.D,

  • Specialist
  • Southbury, CT
  • NPI 1437114071
  Authorized official Same address or phone
• Sandeep Kumar Johar, DO

  • Pain Medicine Physician
  • Waterbury, CT
  • NPI 1174615017
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1306925375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 82",
            "city": "SOUTHBURY",
            "state": "CT",
            "postal_code": "064880082",
            "telephone_number": "203-262-6200",
            "fax_number": "203-262-6205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 POVERTY ROAD",
            "city": "SOUTHBURY",
            "state": "CT",
            "postal_code": "06488",
            "telephone_number": "203-262-6200",
            "fax_number": "203-262-6205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POMPERAUG PLASTIC SURGERY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WAITZE",
        "authorized_official_first_name": "SEUNG-YEUN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "203-262-6200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter J Piliero, MD
• Donna Podurgiel
• Holly Poglitsch, M.S.
• Ellen Polokoff, MD
• Pomperaug Chiropractic and Holistic Center, PC
• Pomperaug Woods, Inc. (Pomperaug Woods Health Center)
• Aysia Starr Porter, DPT
• Prestige Companion & Homemakers, LLC
• Prime Weight Loss LLC
• Progressive Eye Care Inc

• Specialist in Southbury, CT
• Providers in Southbury, CT by specialty
• Specialist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.