AFFILIATED FOOT SURGEONS PC NPI 1760690572

NPI Information

NPI: 1760690572
Provider Name: AFFILIATED FOOT SURGEONS PC
Classification: Podiatrist - 213ES0103X
Entity Type: Organization

Specialization: Foot & Ankle Surgery

CLIA Number: 07D0098763

Address:
508 BLAKE ST
NEW HAVEN, CT
ZIP 06515
Phone: (203) 397-0624
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AFFILIATED FOOT SURGEONS PC is a foot and ankle surgery podiatrist in New Haven, CT. AFFILIATED FOOT SURGEONS PC NPI is 1760690572. The provider is registered as an organization entity type.

The provider's business location address is:

508 BLAKE ST
NEW HAVEN, CT
ZIP 06515-287
Phone: (203) 397-0624
Fax: (203) 397-0372

The provider's authorized official is Peter Andrew Blume .
The authorized official title is President and has the following contact phone number (203) 397-0624.

The CLIA number assigned to this NPI record is 07D0098763 - practitioner other with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 5/18/2007 and was last updated on 12/7/2011.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	335E00000X	Prosthetic/Orthotic Supplier				No
2	332BC3200X	Durable Medical Equipment & Medical Supplies	Customized Equipment	00581	CONNECTICUT	No
3	213ES0103X	Podiatrist	Foot & Ankle Surgery			Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0639830001	MEDICARE NSC	CONNECTICUT
2	C01122	MEDICARE ID-TYPE UNSPECIFIED	CONNECTICUT	MEDICARE GROUP ID
3	004128808	MEDICAID	CONNECTICUT

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

NPI Synchronization or Removal

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