| NPI | 1699802090 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES M DEJESUS Podiatrist 203-723-7884 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213EP1101X Podiatrist, Primary Podiatric Medicine |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2022-09-14 |