Healthcare Provider Details

I. General information

NPI: 1235281288
Provider Name (Legal Business Name): BLOOMFIELD FOOT SPECIALISTS,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2007
Last Update Date: 08/21/2025
Certification Date: 08/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

705 BLOOMFIELD AVE STE 201
BLOOMFIELD CT
06002-2480
US

IV. Provider business mailing address

705 BLOOMFIELD AVE STE 201
BLOOMFIELD CT
06002-2480
US

V. Phone/Fax

Practice location:
  • Phone: 860-243-2951
  • Fax: 860-243-5790
Mailing address:
  • Phone: 860-243-2951
  • Fax: 860-243-5790

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number000530
License Number StateCT

VIII. Authorized Official

Name: DR. LYNN M LEBLANC
Title or Position: PODIATIRST
Credential: D.P.M.
Phone: 860-243-1951