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Organization

WATERBURY PODIATRY CONSULTANTS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MARC RICHARD BERNBACH DPM (DR. / OWNER)
(203) 753-2048
Entity
Organization

Contact information

Practice address
171 GRANDVIEW AVE, SUITE 104, WATERBURY, CT 06708-2517
(203) 753-2048
(203) 753-5891
Mailing address
171 GRANDVIEW AVE, SUITE 104, WATERBURY, CT 06708-2517
(203) 753-2048
(203) 753-5891

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
000447
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
409031
CT
Enumeration date
11/07/2007
Last updated
10/23/2012
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