NEWTOWN SPORTS PODIATRY NPI 1942218763

NPI Information

NPI: 1942218763
Provider Name: NEWTOWN SPORTS PODIATRY
Classification: Podiatrist - 213ES0000X
Entity Type: Organization

Specialization: Sports Medicine

Address:
54 S MAIN ST
NEWTOWN, CT
ZIP 06470
Phone: (203) 426-7060
Get Directions

NEWTOWN SPORTS PODIATRY is a sports medicine podiatrist in Newtown, CT. NEWTOWN SPORTS PODIATRY NPI is 1942218763. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

54 S MAIN ST
NEWTOWN, CT
ZIP 06470-358
Phone: (203) 426-7060
Fax: (203) 270-0420

The provider's authorized official is Brian W Fullem .
The authorized official title is Owner and has the following contact phone number (203) 426-7060.

The enumeration date for this NPI number is 8/4/2006 and was last updated on 3/9/2010.

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	213ES0000X	Podiatrist	Sports Medicine	000556	CONNECTICUT	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
1	004112851	MEDICAID	CONNECTICUT
2	U19859	MEDICARE UPIN	CONNECTICUT
3	6085810001	MEDICARE NSC	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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