Organization
PODIATRYCARE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT E MARRA DPM (PRESIDENT)
(860) 741-3041
Entity
Organization
Contact information
Practice address
1350 SULLIVAN AVE, SOUTH WINDSOR, CT 06074-2760
(860) 644-6525
(860) 741-5644
Mailing address
1379 ENFIELD ST, ENFIELD, CT 06082-5524
(860) 741-3041
(860) 741-5644
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0240710002
DME
CT
Enumeration date
04/24/2015
Last updated
08/24/2023
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