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NPI Code Detail

MEDICARE: HARTFORD PODIATRY GROUP LLC

MEDICARE: HARTFORD PODIATRY GROUP LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1213ES0103XFoot & Ankle Surgery Podiatrist
2332B00000XDurable Medical Equipment & Medical Supplies
3213E00000XPodiatrist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
21086961414OTHERCTCIGNA

General Provider Information

NPI Number : 1083691414
Entity Type Code : Organization
Provider Name (Legal Business Name) : HARTFORD PODIATRY GROUP LLC
Provider Business Mailing Address
First Line : 999 ASYLUM AVE FIRST FLR
Second Line : SUITE 111
City : HARTFORD
State : CT
Zip : 06105-2416
Country : US
Telephone Number : 860-523-8026
Fax Number : 860-523-7622
Provider Business Practice Location Address
First Line : 999 ASYLUM AVE FL 1
Second Line :
City : HARTFORD
State : CT
Zip : 06105-2475
Country : US
Telephone Number : 860-523-8026
Fax Number : 860-523-7622
Authorized Official
Title or Position : PARTNER
Name : DR. ROBERT DAVID RUTSTEIN
Credential : DPM
Telephone Number : 860-523-8026
Provider Enumeration Date : 12/28/2005
Last Update Date : 11/21/2024

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Directions to “HARTFORD PODIATRY GROUP LLC ” Practice Location

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