Provider Demographics
NPI:1700038858
Name:SPARTA, KHRISTINE A (DPM)
Entity Type:Individual
Prefix:DR
First Name:KHRISTINE
Middle Name:A
Last Name:SPARTA
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 1:1881 POST RD
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06824-5721
Mailing Address - Country:US
Mailing Address - Phone:908-337-1969
Mailing Address - Fax:203-259-3444
Practice Address - Street 1:83 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:NORTH HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06473-1704
Practice Address - Country:US
Practice Address - Phone:203-787-3800
Practice Address - Fax:203-787-0004
Is Sole Proprietor?:No
Enumeration Date:2008-10-21
Last Update Date:2013-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT878213ES0103X
NJ25MD00307100213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1295850204OtherASSOCIATED PODIATRISTS OF NORTH HAVEN, LLC GROUP NPI
NJ25MD00307100OtherNJ LICENCE
CT1700985835OtherASSOCIATED PODIATRISTS OF FAIRFIELD, LLC GROUP NPI