MANCHESTER PODIATRY CENTER, PC NPI 1023294808

Durable Medical Equipment & Medical Supplies in Manchester, CT

NPI 1023294808 Organization Durable Medical Equipment & Medical Supp...

About MANCHESTER PODIATRY CENTER, PC

Manchester Podiatry Center,pc is a provider established in Manchester, Connecticut specializing in durable medical equipment & medical supplies. The NPI number of Manchester Podiatry Center,pc is 1023294808 and was assigned on January 2008. The practitioner's primary taxonomy code is 332B00000X. The provider is registered as an organization and their NPI record was last updated 10 years ago. The authorized official of this NPI record is Dr. Kenneth L. Wichman Dpm (Podiatrist)

NPI

1023294808

Provider NameMANCHESTER PODIATRY CENTER,PC
Provider Location Address117 E CENTER ST MANCHESTER, CT 06040
Provider Mailing Address117 E CENTER ST MANCHESTER, CT 06040
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date01-11-2008
Last Update Date04-15-2011


Primary Taxonomy

Taxonomy Code332B00000X
ClassificationDurable Medical Equipment & Medical Supplies
TypeSuppliers
Taxonomy DescriptionA supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.

Business Address

MANCHESTER PODIATRY CENTER,PC
117 E CENTER ST
MANCHESTER, CT
ZIP 06040
Phone: (860) 649-3338

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Mailing Address

MANCHESTER PODIATRY CENTER,PC
117 E CENTER ST
MANCHESTER, CT
ZIP 06040
Phone: (860) 649-3338



Authorized Official

Authorized Official NameDR. KENNETH L. WICHMAN DPM
Authorized Official TitlePODIATRIST
Authorized Official Phone(860) 649-3338

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
0717130001MEDICARE NSC (07)CT

Other Providers at the same location


The following 12 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1922074020DR. KENNETH LEE WICHMAN DPM
Individual
Podiatrist117 E CENTER ST
MANCHESTER, CT 06040
(860) 649-3338
1750457826 ALYSON THERESA BAPTISTE-PARENT LADC
Individual
Counselor (Addiction (Substance Use Disorder))117 E CENTER ST
MANCHESTER, CT 06040
(860) 643-7421
1124206982MR. MATTHEW PAUL BOHONOWICZ LPC
Individual
Counselor (Professional)117 E CENTER ST
MANCHESTER, CT 06040
(860) 890-8689
1518284421FAMILY TRANSITIONS PSYCHOTHERAPY, LLC
Organization
Marriage & Family Therapist117 E CENTER ST
MANCHESTER, CT 06040
(860) 604-8334
1912253071ADVANCED PSYCHOLOGICAL SERVICES, LLC
Organization
Psychologist (Clinical)117 E CENTER ST
MANCHESTER, CT 06040
(860) 604-9268
1477800837DR. ENEIDA M. SILVA PHD
Individual
Psychologist (Clinical)117 E CENTER ST
MANCHESTER, CT 06040
(860) 604-9268
1982961397MONGARE FOOT & ANKLE CARE
Organization
Podiatrist (Primary Podiatric Medicine)117 E CENTER ST
MANCHESTER, CT 06040
(860) 432-1358
1013353515MR. MICHAEL WILLIAM WINAKOR LCSW
Individual
Counselor (Mental Health)117 E CENTER ST
MANCHESTER, CT 06040
(860) 578-4808
1134574155 TRACY FUNKE
Individual
Counselor (Mental Health)117 E CENTER ST
MANCHESTER, CT 06040
(860) 990-9870
1316490097MS. EMILY D LEWIS LCSW
Individual
Social Worker (Clinical)117 E CENTER ST
MANCHESTER, CT 06040
(860) 812-4322
1053813618 NURIYE RUMELI
Individual
Counselor (Professional)117 E CENTER ST
MANCHESTER, CT 06040
(203) 400-8585
1659875045REALMS OF LIFE COUNSELING
Organization
Counselor (Professional)117 E CENTER ST
MANCHESTER, CT 06040
(203) 400-8585

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.