Restart Health and Wellness LLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

RESTART HEALTH AND WELLNESS LLC

Practice address

1336 W Main St Ste 2a
Waterbury, CT 06708-3122

Phone

(203) 887-3890

Fax

(844) 833-5610

NPI assigned

Mar 2, 2020

Organization subpart

No

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

Authorized official

Name

Mr. Mohamed Elsamra, MD

Title

Owner

Phone

(203) 887-3890

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1583107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583107200000",
    "number": "1659905313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 ELLIS RD",
            "city": "EAST HAVEN",
            "state": "CT",
            "postal_code": "065124627",
            "telephone_number": "203-888-3890",
            "fax_number": "844-833-5610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1336 W MAIN ST STE 2A",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067083122",
            "telephone_number": "203-887-3890",
            "fax_number": "844-833-5610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESTART HEALTH AND WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-02",
        "last_updated": "2020-03-02",
        "certification_date": "2020-03-02",
        "status": "A",
        "authorized_official_last_name": "ELSAMRA",
        "authorized_official_first_name": "MOHAMED",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "203-887-3890",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 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.