Provider Demographics
NPI:1801032784
Name:CT PODIATRY & FOOT SURGERY, LLC
Entity Type:Organization
Organization Name:CT PODIATRY & FOOT SURGERY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:A
Authorized Official - Last Name:LEVINE
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:860-886-4747
Mailing Address - Street 1:330 WASHINGTON ST
Mailing Address - Street 2:SUITE 310
Mailing Address - City:NORWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06360-2700
Mailing Address - Country:US
Mailing Address - Phone:860-886-4747
Mailing Address - Fax:860-886-4848
Practice Address - Street 1:330 WASHINGTON ST
Practice Address - Street 2:SUITE 310
Practice Address - City:NORWICH
Practice Address - State:CT
Practice Address - Zip Code:06360-2700
Practice Address - Country:US
Practice Address - Phone:860-886-4747
Practice Address - Fax:860-886-4848
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-26
Last Update Date:2008-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty