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General NPI Number Information
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NPI Number | 1164596482
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Entity Type | Organization
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Legal Business Name | PODIATRY GROUP OF NEW BRITAIN/SOUTHINGTON. P.C.
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Dates
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Enumeration Date | 11/20/2006
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Last Update Date | 04/08/2008
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Provider Practice Location Address
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Address Line | 221 N MAIN ST
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City | SOUTHINGTON
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State | CT
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Zip | 06489
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Country | US
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Telephone | 860-621-6828
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Fax | 860-621-6820
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Provider Business Mailing Address
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Address Line | 221 NORTH MAIN ST
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City | SOUTHINGTON
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State | CT
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Zip | 06489
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Country | US
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Telephone | 860-621-6828
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Fax | 860-621-6820
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Authorized Official
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Title or Position | PRES
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Name | DR. LEO M VELEAS
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Credential | DPM
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Telephone | 860-621-6828
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number | 000213
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License Number State | CT
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