Provider Demographics
NPI:1700313814
Name:NEW HAVEN FAMILY FOOT CARE AND SURGERY,LLC
Entity type:Organization
Organization Name:NEW HAVEN FAMILY FOOT CARE AND SURGERY,LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:APARNA
Authorized Official - Middle Name:SINGH
Authorized Official - Last Name:CHAUHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-721-8896
Mailing Address - Street 1:136 SHERMAN AVE STE 503
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06511-5210
Mailing Address - Country:US
Mailing Address - Phone:203-691-9052
Mailing Address - Fax:475-238-8029
Practice Address - Street 1:136 SHERMAN AVE STE 503
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-5210
Practice Address - Country:US
Practice Address - Phone:203-691-9052
Practice Address - Fax:475-238-8029
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-19
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
213E00000X
CT000817261QP1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatric
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT632745OtherCONNECTICARE
CT004270998Medicaid