Newtown Sports Podiatry

LBN: Newtown Sports Podiatry
Newtown Sports Podiatry is an health care organization with primary practice located at 54 S Main St , Newtown CT 06470-2358. The organization recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Sports Medicine, which is considered as the primary health care specialty. Newtown Sports Podiatry can be contacted via phone (203) 426-7060, or through Fullem, Brian W via phone (203) 426-7060.

Contact Information

Primary practice address
54 S Main St Newtown CT 06470-2358
Phone: (203) 426-7060
Fax: (203) 270-0420
Website:
Map and Directions
Authorized official contact:
Name: Fullem, Brian W Doctor of Podiatric Medicine (DPM)
Phone: (203) 426-7060

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Sports Medicine 213ES0000X 000556 Connecticut

Profile Details

NPI number 1942218763
LBN Legal business name Newtown Sports Podiatry
DBA Doing business as
Authorized official Fullem, Brian W Doctor of Podiatric Medicine (DPM)
Entity Organization
Organization subpart 1 No
Enumeration date Aug 4th, 2006
Last updated Mar 9th, 2010 - about 14 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1942218763 NPPES
Connecticut MEDICAID 004112851

Popular Providers