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General NPI Number Information
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NPI Number | 1124262910
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Entity Type | Individual
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Provider Name | ELLE E RIAZATTI DPM
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Gender | Female
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Dates
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Enumeration Date | 04/24/2009
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Last Update Date | 10/08/2009
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Provider Practice Location Address
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Address Line | 87 SOUTH MAIN STREET SUITE 8
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City | NEWTOWN
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State | CT
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Zip | 06470
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Country | US
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Telephone | 203-270-6724
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Fax | 203-270-6728
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Provider Business Mailing Address
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Address Line | 714 CHASE PARKWAY SUITE 4
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City | WATERBURY
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State | CT
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Zip | 06708-3012
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Country | US
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Telephone | 203-755-0489
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Fax | 203-755-7523
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 000689
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License Number State | CT
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