Provider Demographics
NPI:1437347754
Name:MILFORD PODIATRY ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:MILFORD PODIATRY ASSOCIATES, P.C.
Other - Org Name:NEW HAVEN FOOT SURGEONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CREDENTIALLING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-874-6755
Mailing Address - Street 1:32 CHERRY ST
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06460-3429
Mailing Address - Country:US
Mailing Address - Phone:203-874-6755
Mailing Address - Fax:203-877-7849
Practice Address - Street 1:32 CHERRY ST
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06460-3429
Practice Address - Country:US
Practice Address - Phone:203-874-6755
Practice Address - Fax:203-877-7849
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-11
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT0706090003OtherMEDICARE DMERC
CTC13287OtherRAILROAD MEDICARE PIN
CTC13281OtherRAILROAD MEDICARE PIN
CTCB1640OtherRAILROAD MEDICARE PIN
CTC13287OtherRAILROAD MEDICARE PIN
CTCB1640OtherRAILROAD MEDICARE PIN