Healthcare Provider Details

I. General information

NPI: 1275444671
Provider Name (Legal Business Name): CONNECTICUT WEIGHT LOSS CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 POST RD E # 6
WESTPORT CT
06880-5605
US

IV. Provider business mailing address

1701 POST RD E
WESTPORT CT
06880-5605
US

V. Phone/Fax

Practice location:
  • Phone: 646-852-4921
  • Fax: 203-413-5760
Mailing address:
  • Phone: 646-852-4921
  • Fax: 203-413-5760

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0000X
TaxonomyAdolescent Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. KUMUDA KUMAR
Title or Position: MD
Credential: MD
Phone: 646-852-4921