Organization
ANSONIA PODIATRY ASSOCIATES, LLC
Active
Other names
Yale Podiatry Group
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL S TRAVISANO D.P.M. (OWNER)
(203) 734-4806
Entity
Organization
Contact information
Practice address
364 E MAIN ST, ANSONIA, CT 06401-1904
(203) 734-4806
(203) 734-8265
Mailing address
364 E MAIN ST, ANSONIA, CT 06401-1904
(203) 734-4806
(203) 734-8265
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
000678
CT
332B00000X
Durable Medical Equipment & Medical Supplies
000678
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004020517
—
CT
Enumeration date
05/09/2008
Last updated
01/09/2014
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