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General NPI Number Information
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NPI Number | 1700038858
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Entity Type | Individual
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Provider Name | KHRISTINE A SPARTA DPM
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Gender | Female
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Dates
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Enumeration Date | 10/21/2008
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Last Update Date | 01/17/2013
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Provider Practice Location Address
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Address Line | 83 WASHINGTON AVE
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City | NORTH HAVEN
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State | CT
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Zip | 06473-1704
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Country | US
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Telephone | 203-787-3800
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Fax | 203-787-0004
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Provider Business Mailing Address
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Address Line | 1881 POST RD
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City | FAIRFIELD
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State | CT
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Zip | 06824-5721
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Country | US
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Telephone | 908-337-1969
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Fax | 203-259-3444
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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 | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 878
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License Number State | CT
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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 | 25MD00307100
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License Number State | NJ
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