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General NPI Number Information
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NPI Number | 1750308672
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Entity Type | Organization
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Legal Business Name | WEST CONNECTICUT PODIATRY, LLC
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Dates
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Enumeration Date | 07/16/2006
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Last Update Date | 05/10/2013
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Provider Practice Location Address
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Address Line | 235 MAIN ST SUITE #105
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City | DANBURY
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State | CT
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Zip | 06810-6673
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Country | US
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Telephone | 203-730-0009
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Fax | 203-743-0455
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Provider Business Mailing Address
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Address Line | 235 MAIN ST SUITE # 105
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City | DANBURY
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State | CT
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Zip | 06810-6673
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Country | US
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Telephone | 203-730-0009
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Fax | 203-743-0455
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Authorized Official
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Title or Position | PODIATRIST
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Name | DR. RICHARD GOSNAY
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Credential | DPM
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Telephone | 203-730-0009
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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 | 000765
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License Number State | CT
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