Organization Active NPI

Deborah a. Derose, D.P.M.

  • Podiatrist
  • Fairfield, CT
National Provider Identifier
1821283409
Registry record updated Sep 7, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
000304 Issued in CT
Legal business name
DEBORAH A. DEROSE, D.P.M.
Practice address
880 Old Post Rd
Fairfield, CT 06824-8403
Phone
(203) 255-9975
NPI assigned
Sep 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2007

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

Authorized official

Name
Alvin Saul Prusoff
Title
Spouse
Phone
(203) 255-9975

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X 000304 CT Primary

Addresses

Primary practice location

880 Old Post Rd
Fairfield, CT 06824-8403

Mailing address

880 Old Post Rd
Fairfield, CT 06824-8403
Phone (203) 255-9975

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1189123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189123200000",
    "number": "1821283409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "880 OLD POST RD",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068248403",
            "telephone_number": "203-255-9975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "880 OLD POST RD",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068248403",
            "telephone_number": "203-255-9975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEBORAH A. DEROSE, D.P.M.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-07",
        "last_updated": "2007-09-07",
        "status": "A",
        "authorized_official_last_name": "PRUSOFF",
        "authorized_official_first_name": "ALVIN",
        "authorized_official_middle_name": "SAUL",
        "authorized_official_title_or_position": "SPOUSE",
        "authorized_official_telephone_number": "203-255-9975"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "CT",
            "license": "000304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2007; 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.