Provider Demographics
NPI:1043338379
Name:FOOT & ANKLE SPECIALISTS OF CONNECTICUT , PC
Entity type:Organization
Organization Name:FOOT & ANKLE SPECIALISTS OF CONNECTICUT , PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:R
Authorized Official - Last Name:TREADWELL
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:203-748-2220
Mailing Address - Street 1:6 GERMANTOWN RD
Mailing Address - Street 2:
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06810-5005
Mailing Address - Country:US
Mailing Address - Phone:203-748-2220
Mailing Address - Fax:203-748-3672
Practice Address - Street 1:6 GERMANTOWN RD
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810-5005
Practice Address - Country:US
Practice Address - Phone:203-748-2220
Practice Address - Fax:203-748-3672
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
No335E00000XSuppliersProsthetic/Orthotic SupplierGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004396869Medicaid
CT004396869Medicaid
CTCO1489Medicare ID - Type Unspecified