Provider Demographics
NPI:1871531988
Name:MILETO, RICHARD MICHAEL (DPM)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:MICHAEL
Last Name:MILETO
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52 FEDERAL RD
Mailing Address - Street 2:1A
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06810-6162
Mailing Address - Country:US
Mailing Address - Phone:203-792-3668
Mailing Address - Fax:203-796-7478
Practice Address - Street 1:52 FEDERAL RD
Practice Address - Street 2:1A
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810-6162
Practice Address - Country:US
Practice Address - Phone:203-792-3668
Practice Address - Fax:203-796-7478
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-02
Last Update Date:2013-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000598213EP1101X, 213E00000X, 332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004228864Medicaid
CT004126290Medicaid
CT030000598CT01OtherBLUECARE HEALTH PLAN
CT480000535OtherMEDICARE ID
CT480017212OtherRAIL ROAD MEDICARE INDIVIDUAL PTAN #
CT004126290Medicaid
CT480000535OtherMEDICARE ID