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

Table of Contents

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".