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AFFILIATED FOOT CARE CENTER LLC NPI 1295807451


NPI Information

NPI: 1295807451
Provider Name: AFFILIATED FOOT CARE CENTER, LLC
Classification: Podiatrist - 213E00000X
Entity Type: Organization
Address:
470 MAIN ST
MIDDLEFIELD, CT
ZIP 06455
Phone: (860) 349-8500
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AFFILIATED FOOT CARE CENTER, LLC is a podiatrist in Middlefield, CT. The provider is a podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. AFFILIATED FOOT CARE CENTER, LLC NPI is 1295807451. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

470 MAIN ST
MIDDLEFIELD, CT
ZIP 06455-210
Phone: (860) 349-8500
Fax: (860) 349-3081

The provider's authorized official is Gordon E Fosdick .
The authorized official title is Owner/physician and has the following contact phone number (860) 349-8500.

The enumeration date for this NPI number is 11/14/2006 and was last updated on 1/27/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1213E00000XPodiatrist000723CONNECTICUTYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1004206951MEDICAIDCONNECTICUT

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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