Laserwave Podiatry

NPI #1285383877 in Mystic, Connecticut

Provider Information

NPI Number: 1285383877
Entity Type: Organization
Organization Name: Laserwave Podiatry
Primary Specialty: Podiatrist
Enumeration Date: Mar 21, 2022
Last Updated: Mar 8, 2023

Practice Location

Address: 12 ROOSEVELT AVE STE 203
City: Mystic
State: Connecticut
ZIP Code: 06355-2842
Phone: (401) 363-3150

Authorized Official

Name: DR. MICHAEL DA CICERO, DPM
Title: OWNER AND MEDICAL DIRECTOR
Phone: (401) 363-3150

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Podiatrist	213E00000X	Primary

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