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General NPI Number Information
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NPI Number | 1669656534
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Entity Type | Organization
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Legal Business Name | RECONSTRUCTIVE FOOT SURGEON LLC
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Dates
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Enumeration Date | 12/27/2007
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Last Update Date | 09/14/2022
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Provider Practice Location Address
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Address Line | 234 BROAD ST
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City | MILFORD
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State | CT
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Zip | 06460-3278
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Country | US
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Telephone | 203-701-0252
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Fax | 203-876-0937
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Provider Business Mailing Address
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Address Line | 234 BROAD ST
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City | MILFORD
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State | CT
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Zip | 06460-3278
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Country | US
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Telephone | 203-701-0252
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Fax | 203-876-0937
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Authorized Official
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Title or Position | OWNER
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Name | DR. NADIM M RAMADAN
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Credential | DPM
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Telephone | 203-701-0252
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number |
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License Number State |
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