Provider Demographics
NPI:1538135736
Name:AVON FOOT CARE PC
Entity type:Organization
Organization Name:AVON FOOT CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:BUCHBINDER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:860-674-1200
Mailing Address - Street 1:302 WEST MAIN STREET
Mailing Address - Street 2:107
Mailing Address - City:AVON
Mailing Address - State:CT
Mailing Address - Zip Code:06001
Mailing Address - Country:US
Mailing Address - Phone:860-674-1200
Mailing Address - Fax:860-674-1206
Practice Address - Street 1:302 WEST MAIN STREET
Practice Address - Street 2:107
Practice Address - City:AVON
Practice Address - State:CT
Practice Address - Zip Code:06001
Practice Address - Country:US
Practice Address - Phone:860-674-1200
Practice Address - Fax:860-674-1206
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-27
Last Update Date:2018-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT4004560Medicaid
030000010CT03OtherBCBS
CTOG4389OtherCONNECTICARE
CTOG4389OtherCONNECTICARE