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General NPI Number Information
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NPI Number | 1922158666
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Entity Type | Individual
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Provider Name | SATHIYAPAMA ESWARATHASAN D.P.M.
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Gender | Female
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Dates
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Enumeration Date | 01/12/2007
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Last Update Date | 09/08/2023
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Provider Practice Location Address
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Address Line | 2 BROADWAY SUITE 2
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City | NORTH HAVEN
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State | CT
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Zip | 06473
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Country | US
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Telephone | 203-691-9197
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Fax | 203-496-4580
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Provider Business Mailing Address
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Address Line | 2 BROADWAY SUITE 2
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City | NORTH HAVEN
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State | CT
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Zip | 06473
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Country | US
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Telephone | 203-691-9197
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Fax | 203-496-4580
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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 | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 00000
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 000901
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License Number State | CT
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