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CONNECTICUT FOOT CARE CENTERS LLC NPI 1437698685


NPI Information

NPI: 1437698685
Provider Name: CONNECTICUT FOOT CARE CENTERS LLC
Classification: Podiatrist - 213E00000X
Entity Type: Organization

CLIA Number: 07D2065755

Address:
505 WILLARD AVE
BLDG 2-D
NEWINGTON, CT
ZIP 06111
Phone: (860) 666-2078
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CONNECTICUT FOOT CARE CENTERS LLC is a podiatrist in Newington, 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. CONNECTICUT FOOT CARE CENTERS LLC NPI is 1437698685. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

505 WILLARD AVE
BLDG 2-D
NEWINGTON, CT
ZIP 06111-650
Phone: (860) 666-2078
Fax: (860) 665-8247

The provider's authorized official is Jeffrey Steven Kahn .
The authorized official title is Managing Partner and has the following contact phone number (860) 563-1200.

The CLIA number assigned to this NPI record is 07D2065755 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/21/2017 and was last updated on 2/21/2017.


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
1213E00000XPodiatristCT000092CONNECTICUTYes

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
1C01817MEDICARE PINCONNECTICUT

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: 11/14/2023

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