Healthcare Provider Details

I. General information

NPI: 1669539615
Provider Name (Legal Business Name): SAYBROOK PODIATRY ASSOCIATES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/02/2007
Last Update Date: 04/02/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

767 BOSTON POST RD
OLD SAYBROOK CT
06475-2127
US

IV. Provider business mailing address

767 BOSTON POST RD
OLD SAYBROOK CT
06475-2127
US

V. Phone/Fax

Practice location:
  • Phone: 860-388-2641
  • Fax: 860-395-2928
Mailing address:
  • Phone: 860-388-2641
  • Fax: 860-395-2928

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225000000X
TaxonomyOrthotic Fitter
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: DR. CALLIE LAMAY
Title or Position: PODIATRIST-PARTNER
Credential: D.P.M.
Phone: 860-388-2641