Provider Demographics
NPI:1639680879
Name:FOOT & ANKLE SPECIALISTS OF CT PC
Entity Type:Organization
Organization Name:FOOT & ANKLE SPECIALISTS OF CT PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:R
Authorized Official - Last Name:TREADWELL
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:860-747-2200
Mailing Address - Street 1:6 GERMANTOWN ROAD
Mailing Address - Street 2:
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06812
Mailing Address - Country:US
Mailing Address - Phone:203-748-2220
Mailing Address - Fax:203-748-3672
Practice Address - Street 1:7 PICKETT DISTRICT ROAD
Practice Address - Street 2:
Practice Address - City:NEW MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06776
Practice Address - Country:US
Practice Address - Phone:860-355-3139
Practice Address - Fax:860-350-2717
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FOOT & ANKLE SPECIALISTS OF CT PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-10-16
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000714213E00000X
CT000753213E00000X
CT000955213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty