PODIATRY CENTER OF EASTERN CT, LLC (NPI# 1144453895) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144453895 |
| Entity Type | Organization |
| Organization Name | PODIATRY CENTER OF EASTERN CT, LLC |
| Practice Address |
360 Tolland Tpke Ste 2c Manchester CT 06042-1770 |
| Practice Telephone | 8606477727 |
| Practice Fax Number | 8606477559 |
| Mailing Telephone | 8606477727 |
| Mailing Fax Number | 8606477559 |
| Enumeration Date | 2009-08-28 |
| Last Update Date | 2020-03-24 |
| Authorized Official Name | DONNA BOCCELLI (OWNER) |
| Authorized Official Telephone | 8608362997 |
| Authorized Official Credential | D.P.M. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
000769 | CT | Podiatric Medicine & Surgery Service Providers |
| Street Address |
360 TOLLAND TPKE STE 2C |
| City | MANCHESTER |
| State | CT |
| Zip Code | 06042-1770 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407086036 | Leah Kay Ehle | Nurse Practitioner | 360 Tolland Tpke Ste 2c, Manchester, CT 06042-1770 | 2009-07-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275000960 | Nicole Berger | Behavioral Analyst | 199 Tudor Lane, Apartment E, Manchester, CT 06042 | 2018-10-31 |
| 1902336522 | Karen Scandura | Pharmacist | 260 North Main Street, Manchester, CT 06042 | 2017-06-15 |
| 1053727479 | Sph3enterprise, LLC | Dentist | 194 Buckland Hills Drive, Manchester, CT 06042 | 2014-07-07 |
| 1962657288 | Anthony Michael Gioscia | Optometrist | 344v Buckland Hills Dr, Manchester, CT 06042 | 2008-12-01 |
| 1467635714 | Linda Fernald Gates | Dietitian, Registered | 300 Parker St, Manchester, CT 06042 | 2007-12-10 |
| 1669513909 | Carlos Alfonso Gonzalez | Psychiatry & Neurology | 317 North Main Street, C/o Ccgc, Manchester, CT 06042 | 2007-02-09 |
| 1942350467 | Lise G. O'neill | Counselor | Manchester Memorial Hospital, 71 Haynes St, Manchester, CT 06042 | 2007-01-10 |
| 1558439398 | Jason Allen Sousa | Chiropractor | 1127 Tolland Turnpike, Suite 102, Manchester, CO 06042 | 2006-12-01 |
| 1245332444 | Sharon Soria | Dentist | 192 Main Street, Manchester, TN 06042 | 2006-09-01 |
| 1699732206 | First Choice Health Centers, Inc. | Clinic/Center | 150 N Main St Ste 240, Manchester, CT 06042 | 2006-04-27 |
| Find all providers in zip 06042 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376987537 | Kristin Tiffany Visco | Podiatrist | 424 Hanover St, Manchester, NH 03104-5101 | 2013-04-18 |
| 1033216122 | Peter Kasyjanski | Podiatrist | 424 Hanover Street, Manchester, NH 03104 | 2006-09-20 |
| 1922009216 | Mark B Superstein | Podiatrist | 108 N Spring St, Manchester, TN 37355-1563 | 2005-08-09 |
| 1316232382 | Eric B Bouldin | Podiatrist | 108 N Spring St, Manchester, Manchester, TN 37355-1563 | 2011-06-17 |
| 1649403080 | Cristi Lee Bouldin | Podiatrist | 108 N Spring St, Manchester, TN 37355-1563 | 2009-09-02 |
| 1437306198 | Middle Tennessee Foot Associates P C | Podiatrist | 108 N Spring St, Manchester, TN 37355-1563 | 2008-08-25 |
| 1952589434 | Connecticut Surgical Group, PC | Podiatrist | 29 Haynes St, Manchester, CT 06040-4139 | 2008-02-06 |
| 1639360381 | Luke C Jeffries | Podiatrist | 424 Hanover Street, Manchester, NH 03104 | 2007-08-07 |
| 1013075993 | Barry Alan Frank | Podiatrist | 384 Wilson St, Manchester, NH 03103-4912 | 2006-12-05 |
| 1720170368 | Steven R Rudman | Podiatrist | 424 Hanover Street, Manchester, NH 03104 | 2006-09-29 |
| Find all providers in MANCHESTER | ||||
| City | MANCHESTER |
| Zip Code | 06042 |
Please comment or provide details below to improve the information on PODIATRY CENTER OF EASTERN CT, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.