Healthcare Provider Details

I. General information

NPI: 1417115239
Provider Name (Legal Business Name): ALICIA MAUREEN TEAUSANT DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2008
Last Update Date: 06/07/2026
Certification Date: 06/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 SPRINGS RD
BEDFORD MA
01730-1114
US

IV. Provider business mailing address

255 NORTH RD UNIT 44
CHELMSFORD MA
01824-1422
US

V. Phone/Fax

Practice location:
  • Phone: 781-687-2000
  • Fax:
Mailing address:
  • Phone: 480-993-8767
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberE5408
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: