Jacques Edouard Etienne, M.D., F.A.A.P

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

042829 Issued in CT

Practice address

205 Main St. 1St FL
Optimum Medical LLC
Danbury, CT 06810

Phone

(203) 794-9000

Fax

(203) 794-9005

NPI assigned

Jul 4, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305072000000",
    "number": "1902836976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 MAIN ST. 1ST FL",
            "address_2": "OPTIMUM MEDICAL LLC",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "06810",
            "telephone_number": "203-794-9000",
            "fax_number": "203-794-9005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 MAIN ST. 1ST FL",
            "address_2": "OPTIMUM MEDICAL LLC",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "06810",
            "telephone_number": "203-794-9000",
            "fax_number": "203-794-9005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETIENNE",
        "first_name": "JACQUES",
        "middle_name": "EDOUARD",
        "name_prefix": "Mr.",
        "credential": "M.D., F.A.A.P",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2011-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CT",
            "license": "042829",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "233345-1",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008023919",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christian D Espana Schmidt, MD
• Jeffrey Espino I
• Joseph G. Esposito, PT
• Victor Estaba, M.D.
• Scott Estabrook, M.D.
• Joyce Lynn Eum
• Todd Everett, MD
• Evolution Chiropractic, LLC
• Evolve Foot and Woundcare
• Angela Fabian

• Pediatrics Physician in Danbury, CT
• Providers in Danbury, CT by specialty
• Pediatrics Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2011; 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.