Healthcare Provider Details

I. General information

NPI: 1295920908
Provider Name (Legal Business Name): PREFERRED FOOTCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2007
Last Update Date: 06/18/2024
Certification Date: 06/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 BEDFORD ST
STAMFORD CT
06905-5305
US

IV. Provider business mailing address

1100 BEDFORD ST
STAMFORD CT
06905-5305
US

V. Phone/Fax

Practice location:
  • Phone: 203-975-9600
  • Fax: 203-323-8430
Mailing address:
  • Phone: 203-975-9600
  • Fax: 203-323-8430

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number00693
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: DR. JEREMY A BIER
Title or Position: OWNER
Credential: DPM
Phone: 203-975-9600