Provider Demographics
NPI:1245938323
Name:COASTLINE FOOT AND ANKLE SPECIALISTS LLC
Entity type:Organization
Organization Name:COASTLINE FOOT AND ANKLE SPECIALISTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/CO-FOUNDER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAL
Authorized Official - Middle Name:M
Authorized Official - Last Name:SZPARA
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:203-767-8478
Mailing Address - Street 1:131 BOSTON POST RD
Mailing Address - Street 2:
Mailing Address - City:EAST LYME
Mailing Address - State:CT
Mailing Address - Zip Code:06333-1605
Mailing Address - Country:US
Mailing Address - Phone:860-739-1944
Mailing Address - Fax:860-739-1974
Practice Address - Street 1:131 BOSTON POST RD
Practice Address - Street 2:
Practice Address - City:EAST LYME
Practice Address - State:CT
Practice Address - Zip Code:06333-1605
Practice Address - Country:US
Practice Address - Phone:860-739-1944
Practice Address - Fax:860-739-1974
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-20
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty