| NPI | 1396875365 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT EDWARD MARRA President Owner 860-741-3041 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: CT P00373) |
| Additional Taxonomies | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: CT 000731) |
| 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: CT 000303) | |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2025-09-05 |