| NPI | 1205050630 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ODIN ANTHONY DE LOS REYES Podiatrist 203-262-6100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: CT CT000680) |
| Enumeration Date | 2007-04-13 |
| Last Update Date | 2020-09-23 |