Provider Demographics
NPI:1679518047
Name:TODD A BELL DPM,LLC
Entity type:Organization
Organization Name:TODD A BELL DPM,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:BELL
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:860-286-9161
Mailing Address - Street 1:57 JOLLEY DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:BLOOMFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06002-3062
Mailing Address - Country:US
Mailing Address - Phone:860-286-9161
Mailing Address - Fax:860-242-1388
Practice Address - Street 1:57 JOLLEY DR
Practice Address - Street 2:SUITE A
Practice Address - City:BLOOMFIELD
Practice Address - State:CT
Practice Address - Zip Code:06002-3062
Practice Address - Country:US
Practice Address - Phone:860-286-9161
Practice Address - Fax:860-242-1388
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-18
Last Update Date:2009-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0472213ES0131X, 332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004093762Medicaid
CT3857930001OtherNSC
CTT22923Medicare UPIN
CTC03537Medicare PIN
CT3857930001Medicare NSC