Healthcare Provider Details

I. General information

NPI: 1760731228
Provider Name (Legal Business Name): COMPREHENSIVE FOOT CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2012
Last Update Date: 08/30/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 INDEPENDENCE DR
MARLBOROUGH CT
06447-1408
US

IV. Provider business mailing address

8 INDEPENDENCE DR
MARLBOROUGH CT
06447-1408
US

V. Phone/Fax

Practice location:
  • Phone: 860-295-9179
  • Fax: 860-295-9184
Mailing address:
  • Phone: 860-295-9179
  • Fax: 860-295-9184

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: DR. BENEDICT CHARLES VALENTINE II
Title or Position: OWNER
Credential: DPM
Phone: 860-295-9179