Organization
ST VINCENTS MULTISPECIALTY GROUP INC
Active
Parent organization
ST VINCENTS MULTISPECIALTY GROUP INC
Other names
Family Foot & Ankle Specialists
Organization subpart
Yes
Provider details
NPI number
Legal business name
ST VINCENTS MULTISPECIALTY GROUP INC
Authorized official
LLATOYA GAYLE (CREDENTIALING SPECIALIST)
(475) 210-5346
Entity
Organization
Contact information
Practice address
2409 MAIN ST, BRIDGEPORT, CT 06606-5324
(203) 334-6955
(203) 334-2851
Mailing address
2720 MAIN ST, BRIDGEPORT, CT 06606-5363
(475) 210-5346
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
—
—
213EP1101X
Primary Podiatric Medicine Podiatrist
—
—
Other
Enumeration date
07/22/2019
Last updated
07/22/2019
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