Healthcare Provider Details

I. General information

NPI: 1366610958
Provider Name (Legal Business Name): THE FOOT & ANKLE INSTITUTE OF DARIEN LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2008
Last Update Date: 12/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 POST RD
DARIEN CT
06820-4622
US

IV. Provider business mailing address

800 POST RD
DARIEN CT
06820-4622
US

V. Phone/Fax

Practice location:
  • Phone: 203-656-1696
  • Fax: 203-656-1742
Mailing address:
  • Phone: 203-656-1696
  • Fax: 203-656-1696

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number000219
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number000827
License Number StateCT

VIII. Authorized Official

Name: DR. ROBERT F. WEISS
Title or Position: OWNER
Credential: DPM
Phone: 203-656-1696