RIVERSIDE PODIATRY,LLC


Address: 11 Westridge Dr, Avon, CT 06001-3648
Phone: 8604361773

RIVERSIDE PODIATRY,LLC (NPI# 1609354372) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1609354372
Entity Type Organization
Organization Name RIVERSIDE PODIATRY,LLC
Practice Address 11 Westridge Dr
Avon
CT 06001-3648
Practice Telephone 8604361773
Mailing Telephone 8604361773
Enumeration Date 2018-08-03
Last Update Date 2018-08-03
Authorized Official Name DR. JAPHETH OGAMBA MONGARE (PODIATRIST)
Authorized Official Telephone 8604361773
Authorized Official Credential DPM
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 213EP1101X Podiatrist
Specialization: Primary Podiatric Medicine
881 CT Podiatric Medicine & Surgery Service Providers

Office Location

Street Address 11 WESTRIDGE DR
City AVON
State CT
Zip Code 06001-3648

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1194220996 Theresa L. Hixson Social Worker 152 Simsbury Rd., Building 9, Avon, CT 06001 2018-03-26
1851809974 Kathleen Ann Subasic Occupational Therapist 19 Stockbridge Dr, Avon, CT 06001 2018-01-11
1801254297 Vanessa Brodie Psychologist 395 W Avon Rd Ste 1, Avon, CT 06001 2016-02-01
1346614468 Bryan Lilley Physical Therapist 34 Dale Rd., 202, Avon, CT 06001 2015-12-01
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Taxonomy Information

Taxonomy Code 213EP1101X
Grouping Podiatric Medicine & Surgery Service Providers
Classification Podiatrist
Specialization Primary Podiatric Medicine

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1881955664 Manjit Kaur Podiatrist 301 Satori Pkwy Ste 150, Avon, IN 46123-6408 2012-06-07

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1104236199 Sean Wayne Lazarus D.p.m. LLC Podiatrist 764 Campelle Ave, Unitg, West Haven, CT 06516-3786 2014-04-30
1588957872 Mt Podiatry, LLC Podiatrist 1021 Asylum Ave, Apt 407, Hartford, CT 06105-2436 2011-05-19
1497817118 Michael Connor Podiatrist 27 Danbury Rd Fl 3, Wilton, CT 06897-4405 2006-12-16
1629012661 Thomas M Domanick Podiatrist 1825 Barnum Ave, Stratford, CT 06614-5333 2006-06-16
1659320711 Todd Allen Bell Podiatrist 57 Jolley Dr, Unit A, Bloomfield, CT 06002-3062 2006-05-08
1114928074 Michael Jospeh Ackley Podiatrist 714 S Main St, Cheshire, CT 06410-3448 2005-08-02
1831194042 Karana Marie Pierre Podiatrist 471 Barnum Ave, Bridgeport, CT 06608-2409 2005-06-15
1205479243 Nili T Harpaz Podiatrist 309 Seaside Ave, Milford, CT 06460-4625 2019-10-22
1205489077 St Vincents Multispecialty Group Inc Podiatrist 2409 Main St, Bridgeport, CT 06606-5324 2019-07-22
1215271713 Primed, LLC Podiatrist 4699 Main St, Suite 211, Bridgeport, CT 06606-1830 2012-11-21
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Competitor

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City AVON
Zip Code 06001

Improve Information

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Dataset Information

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.

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