Provider Demographics
NPI:1275929291
Name:CT FAMILY FOOT CARE AND SURGERY, LLC
Entity Type:Organization
Organization Name:CT FAMILY FOOT CARE AND SURGERY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LORI
Authorized Official - Middle Name:K
Authorized Official - Last Name:PARAGAS
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:203-288-0129
Mailing Address - Street 1:1952 WHITNEY AVE.
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06517
Mailing Address - Country:US
Mailing Address - Phone:203-288-0129
Mailing Address - Fax:203-288-1858
Practice Address - Street 1:1952 WHITNEY AVE.
Practice Address - Street 2:3RD FLOOR
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06517
Practice Address - Country:US
Practice Address - Phone:203-288-0129
Practice Address - Fax:203-288-1858
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-07
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000760213E00000X, 261QP1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
No261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatricGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1275929291OtherNPI
CT1326602004OtherNPI
1477535904OtherNPI