Provider Demographics
NPI:1588611792
Name:GOSNAY, RICHARD NONE (DPM)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:NONE
Last Name:GOSNAY
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 MAIN ST
Mailing Address - Street 2:SUITE 105
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06810-6606
Mailing Address - Country:US
Mailing Address - Phone:203-730-0009
Mailing Address - Fax:203-743-0455
Practice Address - Street 1:235 MAIN ST
Practice Address - Street 2:SUITE 105
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810-6606
Practice Address - Country:US
Practice Address - Phone:203-730-0009
Practice Address - Fax:203-743-0455
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-31
Last Update Date:2017-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000765213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
D400085933Medicare PIN
CTD100085930Medicare PIN