Provider Demographics
NPI:1902015662
Name:FOOT AND ANKLE SPECIALISTS OF CT,P.C.
Entity Type:Organization
Organization Name:FOOT AND ANKLE SPECIALISTS OF CT,P.C.
Other - Org Name:DAVID G. SHARNOFF, DMP, P.C.
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:G
Authorized Official - Last Name:SHARNOFF
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:203-924-4747
Mailing Address - Street 1:9 COTS ST
Mailing Address - Street 2:
Mailing Address - City:SHELTON
Mailing Address - State:CT
Mailing Address - Zip Code:06484-3866
Mailing Address - Country:US
Mailing Address - Phone:203-924-4747
Mailing Address - Fax:
Practice Address - Street 1:9 COTS ST
Practice Address - Street 2:
Practice Address - City:SHELTON
Practice Address - State:CT
Practice Address - Zip Code:06484-3866
Practice Address - Country:US
Practice Address - Phone:203-924-4747
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2019-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000184332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT5020099OtherCIGNA
CT004006565Medicaid
CT768326OtherCONNECTICARE
CT030000184CT01OtherANTHEM BCBS
CT41608OtherAETNA HEALTH PLAN
CT1234290001Medicare NSC