Provider Demographics
NPI:1710988985
Name:AFFILIATED PODIATRISTS LLC
Entity Type:Organization
Organization Name:AFFILIATED PODIATRISTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMIR
Authorized Official - Middle Name:F
Authorized Official - Last Name:ZAKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-942-9141
Mailing Address - Street 1:2A TOPSTONE DR
Mailing Address - Street 2:
Mailing Address - City:BETHEL
Mailing Address - State:CT
Mailing Address - Zip Code:06801-2624
Mailing Address - Country:US
Mailing Address - Phone:203-942-9141
Mailing Address - Fax:
Practice Address - Street 1:2A TOPSTONE DR
Practice Address - Street 2:
Practice Address - City:BETHEL
Practice Address - State:CT
Practice Address - Zip Code:06801-2624
Practice Address - Country:US
Practice Address - Phone:203-942-9141
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-09
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000749213E00000X, 213EP0504X, 213EP1101X, 213ER0200X, 213ES0000X, 213ES0131X, 332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
No213EP0504XPodiatric Medicine & Surgery Service ProvidersPodiatristPublic MedicineGroup - Single Specialty
No213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric MedicineGroup - Single Specialty
No213ER0200XPodiatric Medicine & Surgery Service ProvidersPodiatristRadiologyGroup - Single Specialty
No213ES0000XPodiatric Medicine & Surgery Service ProvidersPodiatristSports MedicineGroup - Single Specialty
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT9577804OtherCIGNA
CT004216299Medicaid
CTP00058892OtherRAILROAD MEDICARE
CTP2630726OtherOXFORD
CT030000749CT02OtherANTHEM
CT9577804OtherCIGNA
CTP00058892OtherRAILROAD MEDICARE
CTP2630726OtherOXFORD
CT=========OtherN AMERICAN ADMINISTRATOR
CT=========OtherHMC PPO
CTP2630726OtherOXFORD
CTU85694Medicare UPIN
CT480000906Medicare PIN