1831292804 NPI number — ADVANCED PODIATRIC SPECIALISTS, PC

Table of content: MRS. DENIKA CHACON LCSW 86269 (NPI 1346715893)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831292804 NPI number — ADVANCED PODIATRIC SPECIALISTS, PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ADVANCED PODIATRIC SPECIALISTS, PC
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:
Provider Other Organization Name Type Code:
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:
1831292804
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/03/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1389 W MAIN ST
Provider Second Line Business Mailing Address:
SUITE 222
Provider Business Mailing Address City Name:
WATERBURY
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06708-3104
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
203-757-9200
Provider Business Mailing Address Fax Number:
203-757-3990

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1389 W MAIN ST
Provider Second Line Business Practice Location Address:
SUITE 222
Provider Business Practice Location Address City Name:
WATERBURY
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06708-3104
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-757-9200
Provider Business Practice Location Address Fax Number:
203-757-3990
Provider Enumeration Date:
09/06/2006

Additional Information

Authorized Official

Authorized Official Last Name:
ARENA
Authorized Official First Name:
CHARLES
Authorized Official Middle Name:
T
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
203-757-9200

Provider Taxonomy Codes

  • Taxonomy code: 335E00000X , with the licence number:  P00007 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 213E00000X , with the licence number: P00007 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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