Healthcare Provider Details

I. General information

NPI: 1083699052
Provider Name (Legal Business Name): JAMES P IOLI DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/13/2005
Last Update Date: 12/04/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 FRANCIS ST DEPT OF ORTHOPEODIC SURGERY
BOSTON MA
02115
US

IV. Provider business mailing address

75 FRANCIS ST DEPT OF ORTHOPEODIC SURGERY
BOSTON MA
02115
US

V. Phone/Fax

Practice location:
  • Phone: 617-732-5391
  • Fax: 617-264-6305
Mailing address:
  • Phone: 617-732-5391
  • Fax: 617-264-6305

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number1513
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: