Healthcare Provider Details

I. General information

NPI: 1194712349
Provider Name (Legal Business Name): JEFFREY M. DELOTT D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2005
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

84 N MAIN ST
BRANFORD CT
06405-3061
US

IV. Provider business mailing address

2 BARNES INDUSTRIAL RD S
WALLINGFORD CT
06492-2486
US

V. Phone/Fax

Practice location:
  • Phone: 203-483-2509
  • Fax: 203-483-2513
Mailing address:
  • Phone: 203-626-0160
  • Fax: 203-294-6734

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number00747
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number000747
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: