Provider Demographics
NPI:1639270044
Name:BETSCHART, PAUL J (DPM)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:J
Last Name:BETSCHART
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:57 NORTH ST
Mailing Address - Street 2:SUITE 108
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06810-5660
Mailing Address - Country:US
Mailing Address - Phone:203-791-0466
Mailing Address - Fax:203-791-2001
Practice Address - Street 1:57 NORTH ST
Practice Address - Street 2:SUITE 108
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810-5660
Practice Address - Country:US
Practice Address - Phone:203-791-0466
Practice Address - Fax:203-791-2001
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2016-02-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYN005002213E00000X
CT000773213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN005002C15OtherHEALTH FIRST
NY1278955OtherUNITED HEALTHCARE MEDICAI
NY1C2751OtherHEALTHNET
NYP706583OtherOXFORD
NY51500OtherELDER PLAN
NY01561339Medicaid
NY6201143OtherGHI
NY480024595OtherRAILROAD MEDICARE
NY939312OtherFIRST HEALTH
NY1278955OtherUNITED HEALTHCARE MEDICAI
NY1278955OtherUNITED HEALTHCARE MEDICAI