Provider Demographics
NPI:1023009768
Name:ARENA, CHARLES T (DPM)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:T
Last Name:ARENA
Suffix:
Gender:M
Credentials:DPM
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Mailing Address - Street 1:1389 WEST MAIN STREET
Mailing Address - Street 2:SUITE 222
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06708
Mailing Address - Country:US
Mailing Address - Phone:203-757-9200
Mailing Address - Fax:
Practice Address - Street 1:1389 WEST MAIN STREET
Practice Address - Street 2:SUITE 222
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06708
Practice Address - Country:US
Practice Address - Phone:203-757-9200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2011-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTP00007213E00000X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1023009768OtherRAILROAD MEDICARE
CT1023009768OtherRAILROAD MEDICARE