CONNECTICUT FOOT SPECIALISTS, P.C. (NPI# 1902124225) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902124225 |
| Entity Type | Organization |
| Organization Name | CONNECTICUT FOOT SPECIALISTS, P.C. |
| Practice Address |
43 Woodland St Suite 210 Hartford CT 06105-2363 |
| Practice Telephone | 2602517200 |
| Mailing Telephone | 8602517200 |
| Enumeration Date | 2010-05-11 |
| Last Update Date | 2010-06-04 |
| Authorized Official Name | DR. BRIAN K WAGNER (OWNER) |
| Authorized Official Telephone | 8606534708 |
| Authorized Official Credential | D.P.M. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 213ES0131X |
Podiatrist Specialization: Foot Surgery |
CT000793 | CT | Podiatric Medicine & Surgery Service Providers |
| Y | 213E00000X | Podiatrist | CT000793 | CT | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | DR. WAGNER'S STATE LICENSE | CT000793 | 01 |
| CT | DR. WAGNER'S NPI | 1093743502 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487684346 | Connecticut Foot Specialists, P.C. | Durable Medical Equipment & Medical Supplies | 11 South Rd Lowr Level20, Farmington, CT 06032-2483 | 2006-07-04 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Connecticut Business Registrations | CONNECTICUT FOOT SPECIALISTS, PC | 133 Hartford Ave, East Granby, CT 06026 |
| Street Address |
43 WOODLAND ST SUITE 210 |
| City | HARTFORD |
| State | CT |
| Zip Code | 06105-2363 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730148909 | Lynn Keyes Davis | Specialist | 43 Woodland St, Suite G-80, Gothic Park, Hartford, CT 06105-2363 | 2006-03-17 |
| 1710587688 | Antonia Sanchez-digrazia | Counselor | 43 Woodland St, Hartford, CT 06105-2363 | 2020-10-29 |
| 1265039911 | Samuel Gipstein | Student in an Organized Health Care Education/Training Program | 43 Woodland St, Hartford, CT 06105-2363 | 2020-10-06 |
| 1619584364 | Laura Elizabeth Sheridan | Registered Nurse | 43 Woodland St, Hartford, CT 06105-2363 | 2020-09-27 |
| 1366056962 | Kimberly Gaznabie | Registered Nurse | 43 Woodland St, Hartford, CT 06105-2363 | 2020-09-02 |
| 1427675594 | Elizabeth Edgaro | Social Worker | 43 Woodland St, Hartford, CT 06105-2363 | 2020-07-06 |
| 1760009914 | Paulette Simon | Registered Nurse | 43 Woodland St, Hartford, CT 06105-2363 | 2020-07-02 |
| 1679197339 | Andea Yvette Bonds | Registered Nurse | 43 Woodland St, Hartford, CT 06105-2363 | 2020-05-28 |
| 1932720133 | Samantha Ann Schiffer | Social Worker | 43 Woodland St, Hartford, CT 06105-2363 | 2020-04-29 |
| 1689295099 | Lourdes Marie Garcia | Social Worker | 43 Woodland St, Hartford, CT 06105-2363 | 2020-04-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275155939 | Pruthwy R Addanki | Student in an Organized Health Care Education/Training Program | Saint Francis Clinic, 1000 Asylum Avenue, Suite 1004, Hartford, CT 06105 | 2020-05-15 |
| 1700447802 | Samuel Flynn | Student in an Organized Health Care Education/Training Program | 1000 Asylum Avenue, Suite 3200, Hartford, CT 06105 | 2019-06-28 |
| 1730743568 | Turab J Mohammed | Student in an Organized Health Care Education/Training Program | Saint Francis Hospital Clinic, 1000 Asylum Avenue, Suite 1004, Hartford, CT 06105 | 2019-04-26 |
| 1164900387 | Breanne Ferrara | Social Worker | 43 Wooland St, Hartford, CT 06105 | 2018-07-31 |
| 1154814069 | Signature Smiles of Hartford LLC | Dentist | 550 Farmington Avenue, Suite B, Hartford, CT 06105 | 2018-06-14 |
| 1356839062 | Jaimy Villavicencio | Student in an Organized Health Care Education/Training Program | 100 Asylum Avenue, Suite 1004, Hartford, CT 06105 | 2018-04-27 |
| 1750885679 | Brittany Bird | Student in an Organized Health Care Education/Training Program | 839-841 Asylum Avenue, Hartford, CT 06105 | 2018-03-23 |
| 1972032241 | Ashley Nicole Mills | Student in an Organized Health Care Education/Training Program | 896 Asylum Ave, 3rd Floor, Hartford, CT 06105 | 2017-06-08 |
| 1528506847 | Samuel Agyei | Social Worker | 291 Collins St, Hartford, CT 06105 | 2017-02-07 |
| 1841735818 | Katie Strahowski | Nurse Practitioner | 85 Gillett Street, Clean Slate, Hartford, CT 06105 | 2016-12-30 |
| Find all providers in zip 06105 | ||||
| Taxonomy Code | 213E00000X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295712891 | Eric Myles Kosofsky | Podiatrist | 597 Farmington Ave, Hartford, CT 06105-3057 | 2005-12-27 |
| 1851643258 | Hartford Healthcare Medical Group, Inc | Podiatrist | 85 Seymour St, Ste. 409, Hartford, CT 06106-5501 | 2012-10-09 |
| 1962783381 | Hartford Clinical Associates, PC | Podiatrist | 85 Seymour St, Suite 409, Hartford, CT 06106-5501 | 2011-08-30 |
| 1144484213 | Connecticut Foot Specialists PC | Podiatrist | 1000 Asylum Avenue, Suite 2100, Hartford, CT 06105 | 2008-07-17 |
| 1588783641 | Irving J Buchbinder | Podiatrist | 500 Albany Avenue, Hartford, CT 06120 | 2007-03-28 |
| 1033155163 | Eric Lui | Podiatrist | 85 Seymour St, Suite 409, Hartford, CT 06106-5501 | 2006-06-20 |
| 1316902273 | Henry F Fedus | Podiatrist | 21 Grand Street, Hartford, CT 06106 | 2006-04-20 |
| 1891774915 | Robert David Rutstein | Podiatrist | 597 Farmington Ave, Hartford, CT 06105-3057 | 2006-01-17 |
| 1053395400 | Connecticut Surgical Group, PC | Podiatrist | 85 Seymour St, Ste 409, Hartford, CT 06106 | 2005-11-30 |
| 1891782165 | Eric W Silverstein | Podiatrist | 85 Seymour St, Suite 409, Hartford, CT 06106-5501 | 2005-10-03 |
| Find all providers in HARTFORD | ||||
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| 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.