MEDICARE: ESTELL PAPPAS DPM

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
1	213E00000X	Podiatrist	000713	CT

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	480001019	OTHER	CT	HSR MEDICARE PIN

Other Identifiers

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

General Provider Information

NPI Number	:	1376547992
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ESTELL PAPPAS DPM

Provider Business Mailing Address
First Line	:	3851 WHITNEY AVE
Second Line	:
City	:	HAMDEN
State	:	CT
Zip	:	06518-1519
Country	:	US
Telephone Number	:	203-745-4002
Fax Number	:	203-553-7233

Provider Business Practice Location Address
First Line	:	3851 WHITNEY AVE
Second Line	:
City	:	HAMDEN
State	:	CT
Zip	:	06518-1519
Country	:	US
Telephone Number	:	203-745-4002
Fax Number	:	203-624-6815

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/10/2005
Last Update Date	:	06/01/2023

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Directions to “ ESTELL PAPPAS DPM” Practice Location

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