Provider Demographics
NPI:1538272943
Name:ETERNO, ROBERT ANTHONY (DPM)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:ANTHONY
Last Name:ETERNO
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:112 QUARRY RD
Mailing Address - Street 2:SUITE 420
Mailing Address - City:TRUMBULL
Mailing Address - State:CT
Mailing Address - Zip Code:06611-4848
Mailing Address - Country:US
Mailing Address - Phone:203-374-1700
Mailing Address - Fax:203-372-1975
Practice Address - Street 1:112 QUARRY RD
Practice Address - Street 2:SUITE 420
Practice Address - City:TRUMBULL
Practice Address - State:CT
Practice Address - Zip Code:06611-4848
Practice Address - Country:US
Practice Address - Phone:203-374-1700
Practice Address - Fax:203-372-1975
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2014-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTP00355213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1014414OtherUS HEALTHCARE
CT000183698OtherUNITED HEALTHCARE
CT0V6199OtherPHS/HEALTHNET
CT6446293-002OtherCIGNA HEALTHCARE
CTZS502OtherOXFORD
CT355000OtherCONNECTICARE
NYP3995OtherEMPIRE BCBS
CT4344487OtherAETNA/USHEALTHCARE
CT030000355CT02OtherANTHEM BCBS
CT4344487OtherAETNA/USHEALTHCARE
CT6446293-002OtherCIGNA HEALTHCARE
CT030000355CT02OtherANTHEM BCBS