| NPI | 1811292675 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN KEY Provider 203-936-6677 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: CT 000781) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: CT 000781) |
| Enumeration Date | 2011-01-25 |
| Last Update Date | 2020-05-22 |