Healthcare Provider Details

I. General information

NPI: 1043338379
Provider Name (Legal Business Name): FOOT & ANKLE SPECIALISTS OF CONNECTICUT , PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2007
Last Update Date: 03/08/2022
Certification Date: 03/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 GERMANTOWN RD
DANBURY CT
06810-5005
US

IV. Provider business mailing address

6 GERMANTOWN RD
DANBURY CT
06810-5005
US

V. Phone/Fax

Practice location:
  • Phone: 203-748-2220
  • Fax: 203-748-3672
Mailing address:
  • Phone: 203-748-2220
  • Fax: 203-748-3672

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: DR. JOSEPH R TREADWELL
Title or Position: PRESIDENT
Credential: DPM
Phone: 203-748-2220