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Organization
YALE COMFORT SHOE CENTER LLC
Active
Organization
YALE COMFORT SHOE CENTER LLC
Active
Other names
Yale Comfort Shoe-Yale Surgical
Organization subpart
No
Provider details
NPI number
Authorized official
MARIE A KAUFMAN (BILLING MANAGER)
(203) 777-2396
Entity
Organization
Contact information
Practice address
305 BOSTON AVE, STRATFORD, CT 06614-5246
(203) 372-7112
(203) 338-8437
Mailing address
627 CHAPEL ST, NEW HAVEN, CT 06511-6992
(203) 777-2396
(203) 777-4617
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004096295
—
CT
01
—
12DME0905CT01
BCBS
CT
01
—
OV6079
HEALTHNET
CT
Enumeration date
08/22/2006
Last updated
07/17/2013
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