Healthcare Provider Details

I. General information

NPI: 1538135736
Provider Name (Legal Business Name): AVON FOOT CARE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2006
Last Update Date: 05/04/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

302 WEST MAIN STREET 107
AVON CT
06001
US

IV. Provider business mailing address

302 WEST MAIN STREET 107
AVON CT
06001
US

V. Phone/Fax

Practice location:
  • Phone: 860-674-1200
  • Fax: 860-674-1206
Mailing address:
  • Phone: 860-674-1200
  • Fax: 860-674-1206

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State

VIII. Authorized Official

Name: DR. STEVEN BUCHBINDER
Title or Position: PRES
Credential: DPM
Phone: 860-674-1200