Provider Demographics
NPI:1013443134
Name:NEW HAVEN FOOT AND ANKLE GROUP,INC
Entity Type:Organization
Organization Name:NEW HAVEN FOOT AND ANKLE GROUP,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:ESTELL
Authorized Official - Middle Name:
Authorized Official - Last Name:PAPPAS
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:203-745-3400
Mailing Address - Street 1:3851 WHITNEY AVE
Mailing Address - Street 2:
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06518-1519
Mailing Address - Country:US
Mailing Address - Phone:203-745-4002
Mailing Address - Fax:203-533-7233
Practice Address - Street 1:3851 WHITNEY AVE
Practice Address - Street 2:
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06518-1519
Practice Address - Country:US
Practice Address - Phone:203-494-1724
Practice Address - Fax:203-533-7233
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-10
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000713213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT480000777Medicare PIN