Dr. Richard I Reaback
Foot Surgery
300 Hebron Ave Suite 104
Glastonbury
, Connecticut 06033-2176
Dr. Richard I Reaback
Foot Surgery
300 Hebron Ave Suite 104
Glastonbury
, Connecticut 06033-2176
(860) 633-1642
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About
Features
Specialties
- Foot Surgery
Languages spoken
- English
Location
First Address
- Dr. Richard I Reaback
- 300 Hebron Ave Suite 104
- Glastonbury, CT
- Zip : 06033-2176
- Fax : (860) 633-1642
- Phone : (860) 633-9004
Second Address
- Dr. Richard I Reaback
- 300 Hebron Ave Suite 104
- Glastonbury, CT
- Zip : 06033-2176
- Fax : (860) 633-1642
- Phone : (860) 633-9004
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 213ES0131X | Foot Surgery | 000306 | CT |
National Provider Identifier
| NPI | 1255310504 |
|---|---|
| Provider Name | Dr. Richard I Reaback |
| First Address | Glastonbury, CT 06033-2176 |
| Second Address | Glastonbury, CT 06033-2176 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 14/01/2006 |
| Last Update Date | 09/04/2010 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 4050761 | (05) | CT |
| T22446 | (02) | CT |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
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?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.