1437347754 NPI number — MILFORD PODIATRY ASSOCIATES, P.C.

Table of content: (NPI 1437347754)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437347754 NPI number — MILFORD PODIATRY ASSOCIATES, P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MILFORD PODIATRY ASSOCIATES, P.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
NEW HAVEN FOOT SURGEONS
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1437347754
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/24/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
32 CHERRY ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MILFORD
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06460-3429
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
203-874-6755
Provider Business Mailing Address Fax Number:
203-877-7849

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
32 CHERRY ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MILFORD
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06460-3429
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-874-6755
Provider Business Practice Location Address Fax Number:
203-877-7849
Provider Enumeration Date:
10/11/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
ALLEN
Authorized Official First Name:
VICTORIA
Authorized Official Middle Name:
Authorized Official Title or Position:
CREDENTIALLING COORDINATOR
Authorized Official Telephone Number:
203-874-6755

Provider Taxonomy Codes

  • Taxonomy code: 213E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 213ES0103X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0706090003 . This is a "MEDICARE DMERC" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: C13287 . This is a "RAILROAD MEDICARE PIN" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: C13281 . This is a "RAILROAD MEDICARE PIN" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: CB1640 . This is a "RAILROAD MEDICARE PIN" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".