NPIMap

Organization Active NPI

Clinic 21 of Connecticut LLC

  • Emergency Medicine Physician
  • Stamford, CT
National Provider Identifier
1760856306
Registry record updated Nov 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
CLINIC 21 OF CONNECTICUT LLC
Practice address
2001 W Main St
#100
Stamford, CT 06902-4501
Phone
(203) 276-8540
Fax
(203) 276-8541
NPI assigned
Nov 19, 2015
Last updated
Nov 19, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2015

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

Authorized official

Name
Thomas J Zyniewicz II, DONPI 1497792733
Title
President
Phone
(330) 493-4443

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X Primary

Addresses

Primary practice location

2001 W Main St
#100
Stamford, CT 06902-4501

Mailing address

4535 Dressler Rd NW
Canton, OH 44718-2545
Phone (330) 493-4443

National Provider Directory

National Provider Directory

Locations

2001 W Main St
Ste 100
Stamford, CT 06902
Phone (203) 276-8540

Practitioners & affiliated clinicians

Practitioners 28

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.

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1447891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447891200000",
    "number": "1760856306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4535 DRESSLER RD NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182545",
            "telephone_number": "330-493-4443",
            "fax_number": "330-493-8677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 W MAIN ST",
            "address_2": "#100",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069024501",
            "telephone_number": "203-276-8540",
            "fax_number": "203-276-8541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINIC 21 OF CONNECTICUT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-19",
        "last_updated": "2015-11-19",
        "status": "A",
        "authorized_official_last_name": "ZYNIEWICZ",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "330-493-4443",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stamford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2015; 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.