Provider Demographics
NPI:1205399912
Name:WASHINGTON PODIATRY LLC
Entity Type:Organization
Organization Name:WASHINGTON PODIATRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ANKUR
Authorized Official - Middle Name:ASHOK
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:203-417-6979
Mailing Address - Street 1:7 COOPERS LN
Mailing Address - Street 2:
Mailing Address - City:NEW MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06776-5328
Mailing Address - Country:US
Mailing Address - Phone:203-417-6979
Mailing Address - Fax:
Practice Address - Street 1:168 NEW MILFORD TPKE UNIT 1A
Practice Address - Street 2:
Practice Address - City:NEW PRESTON MARBLE DALE
Practice Address - State:CT
Practice Address - Zip Code:06777-1601
Practice Address - Country:US
Practice Address - Phone:203-417-6979
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-09
Last Update Date:2019-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty