MEDICARE: FAIRFIELD PODIATRY ASSOCIATES 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
1	213E00000X	Podiatrist

General Provider Information

NPI Number	:	1407047954
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAIRFIELD PODIATRY ASSOCIATES LLC

Provider Business Mailing Address
First Line	:	2321 BLACK ROCK TURNPIKE
Second Line	:
City	:	FAIRFIELD
State	:	CT
Zip	:	06825
Country	:	US
Telephone Number	:	203-372-7445
Fax Number	:	203-372-0506

Provider Business Practice Location Address
First Line	:	2321 BLACK ROCK TURNPIKE
Second Line	:
City	:	FAIRFIELD
State	:	CT
Zip	:	06825-3220
Country	:	US
Telephone Number	:	203-372-7445
Fax Number	:	203-372-0506

Authorized Official
Title or Position	:	CEO OWNER
Name	:	DR. ANTHONY ROBERT IORIO
Credential	:	DPM MPH
Telephone Number	:	203-372-7445

Provider Enumeration Date	:	08/08/2007
Last Update Date	:	03/26/2008

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