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General NPI Number Information
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NPI Number | 1811292675
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Entity Type | Organization
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Legal Business Name | CONNECTICUT FOOT AND ANKLE ASSOCIATES, INC
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Dates
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Enumeration Date | 01/25/2011
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Last Update Date | 05/22/2020
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Provider Practice Location Address
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Address Line | 245 AMITY RD SUITE 110
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City | WOODBRIDGE
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State | CT
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Zip | 06525-2258
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Country | US
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Telephone | 203-936-6677
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Fax | 203-774-3594
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Provider Business Mailing Address
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Address Line | 245 AMITY RD SUITE 110
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City | WOODBRIDGE
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State | CT
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Zip | 06525-2258
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Country | US
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Telephone | 203-936-6677
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Fax | 203-774-3594
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Authorized Official
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Title or Position | PROVIDER
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Name | DR. JONATHAN KEY
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Credential | DPM
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Telephone | 203-936-6677
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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 | 000781
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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 | 000781
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License Number State | CT
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