Footstar Pedorthic Center LLC

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

License

2391 Issued in CT

Legal business name

FOOTSTAR PEDORTHIC CENTER LLC

Practice address

74 Broad St
Milford, CT 06460-3353

Phone

(800) 318-0007

NPI assigned

May 11, 2010

Last updated

May 11, 2010By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Matthew Arcivolo

Title

Owner

Phone

(800) 318-0007

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1273536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1273536000000",
    "number": "1295053668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "74 BROAD ST",
            "city": "MILFORD",
            "state": "CT",
            "postal_code": "064603353",
            "telephone_number": "800-318-0007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "74 BROAD ST",
            "city": "MILFORD",
            "state": "CT",
            "postal_code": "064603353",
            "telephone_number": "800-318-0007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOTSTAR PEDORTHIC CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-11",
        "last_updated": "2010-05-11",
        "status": "A",
        "authorized_official_last_name": "ARCIVOLO",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "800-318-0007"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "CT",
            "license": "2391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John T Fitzpatrick Jr., MD
• Maxwell David Flaugh, PA-C
• Kyle Floryan, DC
• Elena M Foldeak, PHARM D
• Foot & Ankle Physical Therapy & Rehab Medicine
• Jasmine Ford
• Frank John Forte, D.C
• Kenneth M Forte, APRN
• Victor Fossi Nooam
• Chelcia Foster, APRN

• Prosthetic/Orthotic Supplier in Milford, CT
• Providers in Milford, CT by specialty
• Prosthetic/Orthotic Supplier in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.