Provider Demographics
NPI:1376547992
Name:PAPPAS, ESTELL (DPM)
Entity Type:Individual
Prefix:
First Name:ESTELL
Middle Name:
Last Name:PAPPAS
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3851 WHITNEY AVE
Mailing Address - Street 2:
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06518-1519
Mailing Address - Country:US
Mailing Address - Phone:203-745-4002
Mailing Address - Fax:203-553-7233
Practice Address - Street 1:3851 WHITNEY AVE
Practice Address - Street 2:
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06518-1519
Practice Address - Country:US
Practice Address - Phone:203-745-4002
Practice Address - Fax:203-624-6815
Is Sole Proprietor?:No
Enumeration Date:2005-06-10
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000713213E00000X, 213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT480001019OtherHSR MEDICARE PIN
CT004198067Medicaid
CT480001019OtherHSR MEDICARE PIN
CTU74865Medicare UPIN