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Organization
CONNECTICUT FOOT SPECIALISTS PC
Active
Organization
CONNECTICUT FOOT SPECIALISTS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN K WAGNER DPM (OWNER)
(860) 653-4708
Entity
Organization
Contact information
Practice address
1000 ASYLUM AVENUE, SUITE 2100, HARTFORD, CT 06105
(860) 714-3668
(860) 714-8123
Mailing address
133 HARTFORD AVENUE, EAST GRANBY, CT 06026
(860) 653-4708
(860) 653-6249
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
—
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1073542312
DR. POLLACK'S NPI
CT
Enumeration date
07/17/2008
Last updated
09/23/2009
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