Provider Demographics
NPI:1538339080
Name:CHARLOT, FARLYN (DPM)
Entity type:Individual
Prefix:DR
First Name:FARLYN
Middle Name:
Last Name:CHARLOT
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:DR
Other - First Name:FARLYN
Other - Middle Name:
Other - Last Name:CHARLOT-WADLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPM
Mailing Address - Street 1:508 BLAKE ST
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06515-1287
Mailing Address - Country:US
Mailing Address - Phone:203-397-0624
Mailing Address - Fax:
Practice Address - Street 1:508 BLAKE ST
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06515-1287
Practice Address - Country:US
Practice Address - Phone:203-397-0624
Practice Address - Fax:203-397-0372
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-11
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000868213ES0103X, 213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery