Provider Demographics
NPI:1366610958
Name:THE FOOT & ANKLE INSTITUTE OF DARIEN LLC
Entity type:Organization
Organization Name:THE FOOT & ANKLE INSTITUTE OF DARIEN LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:F
Authorized Official - Last Name:WEISS
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:203-656-1696
Mailing Address - Street 1:800 POST RD
Mailing Address - Street 2:
Mailing Address - City:DARIEN
Mailing Address - State:CT
Mailing Address - Zip Code:06820-4622
Mailing Address - Country:US
Mailing Address - Phone:203-656-1696
Mailing Address - Fax:203-656-1696
Practice Address - Street 1:800 POST RD
Practice Address - Street 2:
Practice Address - City:DARIEN
Practice Address - State:CT
Practice Address - Zip Code:06820-4622
Practice Address - Country:US
Practice Address - Phone:203-656-1696
Practice Address - Fax:203-656-1742
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-15
Last Update Date:2012-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000219213ES0103X
CT000827213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT03000219CT02OtherANTHEM
CT4271720OtherAETNA
CTZS157OtherOXFORD
CT2V4170OtherHEALTH NET
CT480000189Medicare UPIN
CTT23261Medicare PIN
CT2V4170OtherHEALTH NET