Healthcare Provider Details

I. General information

NPI: 1003812611
Provider Name (Legal Business Name): THOMAS GARY LAPOINTE D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/28/2005
Last Update Date: 12/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

68 UPSON AVE APT B6
BERLIN CT
06037-1342
US

IV. Provider business mailing address

323 CENTER ST APT B6
WEST HAVEN CT
06516-4301
US

V. Phone/Fax

Practice location:
  • Phone: 203-764-0137
  • Fax:
Mailing address:
  • Phone: 203-764-0137
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number0677
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: