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General NPI Number Information
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NPI Number | 1356521058
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Entity Type | Organization
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Legal Business Name | FEET FIRST FOOT CARE SPECIALISTS, LLC
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Dates
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Enumeration Date | 11/09/2007
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Last Update Date | 10/23/2020
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Provider Practice Location Address
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Address Line | 162 WEST ST STE K
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City | CROMWELL
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State | CT
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Zip | 06416-4405
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Country | US
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Telephone | 860-632-5499
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Fax | 860-632-5515
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Provider Business Mailing Address
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Address Line | 162 WEST ST STE K
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City | CROMWELL
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State | CT
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Zip | 06416-4405
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Country | US
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Telephone | 860-632-5499
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Fax | 860-632-5515
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Authorized Official
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Title or Position | MEMBER
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Name | DR. ADAM MUCINSKAS
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Credential | DPM
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Telephone | 860-632-5499
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 000768
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License Number State | CT
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