# MT MEDICAL, LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Comfort Footwear Etc
- **Organization subpart:** No

## Provider details

- **NPI number:** 1609891597
- **Authorized official:** MR. ILYA TSVOK C-PED (PRESIDENT)
- **Authorized official phone:** (860) 232-1868

## Contact information

- **Practice address:** 208 PARK RD, WEST HARTFORD, CT 06119-2015
- **Practice address phone:** (860) 232-1868
- **Practice address fax:** (860) 761-2658
- **Mailing address:** 208 PARK RD, WEST HARTFORD, CT 06119-2015
- **Mailing address phone:** (860) 232-1868
- **Mailing address fax:** (860) 761-2658

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 335E00000X | Prosthetic/Orthotic Supplier | — | NULL | Yes |

## Other

- **Enumeration date:** 07/13/2006
- **Last updated:** 07/20/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 004214269 | — | CT |