Provider Demographics
NPI:1225193519
Name:MILFORD FOOTCARE LLC
Entity Type:Organization
Organization Name:MILFORD FOOTCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:A
Authorized Official - Last Name:BORSOS
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:203-878-2642
Mailing Address - Street 1:990 BRIDGEPORT AVENUE
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06460-3143
Mailing Address - Country:US
Mailing Address - Phone:203-878-2642
Mailing Address - Fax:203-877-0849
Practice Address - Street 1:990 BRIDGEPORT AVENUE
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06460-3143
Practice Address - Country:US
Practice Address - Phone:203-878-2642
Practice Address - Fax:203-877-0849
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTC02815Medicare ID - Type UnspecifiedGROUP