Provider Demographics
NPI:1184788861
Name:MILFORD PODIATRY ASSOCIATES PC
Entity type:Organization
Organization Name:MILFORD PODIATRY ASSOCIATES PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:M
Authorized Official - Last Name:PRESSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:203-874-6755
Mailing Address - Street 1:318 NEW HAVEN AVE
Mailing Address - Street 2:UNIT A
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06460-6661
Mailing Address - Country:US
Mailing Address - Phone:203-878-9622
Mailing Address - Fax:203-878-9622
Practice Address - Street 1:318 NEW HAVEN AVE
Practice Address - Street 2:UNIT A
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06460-6661
Practice Address - Country:US
Practice Address - Phone:203-878-9622
Practice Address - Fax:203-878-9622
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-20
Last Update Date:2011-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0161261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTIV5656OtherHEALTHNET
CT6840016OtherUNITED HEALTHCARE
CT2770673-001OtherCIGNA HEALTHCARE
CT5125138OtherAETNA
CT764554OtherCONNECTICARE
CT320OtherANTHEM BLUE CROSS
CT004216900Medicaid
CT6840016OtherUNITED HEALTHCARE