Organization
CONNECTICUT FOOT CARE CENTERS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY STEVEN KAHN D.P.M (MANAGING PARTNER)
(860) 563-1200
Entity
Organization
Contact information
Practice address
300 HEBRON AVE, SUITE 105, GLASTONBURY, CT 06033-2176
(860) 633-6749
(860) 633-8168
Mailing address
PO BOX 37, ROCKY HILL, CT 06067-0037
(860) 563-1200
(860) 563-2665
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C01816
MEDICARE GROUP PTAN
CT
01
—
C01817
MEDICARE GROUP PTAN
CT
Enumeration date
12/04/2007
Last updated
05/01/2008
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