Healthcare Provider Details

I. General information

NPI: 1609804442
Provider Name (Legal Business Name): JAMES C SANG D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2006
Last Update Date: 06/24/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 S HUNTINGTON AVE SUITE 3C14
BOSTON MA
02130-4817
US

IV. Provider business mailing address

183 OAK ST APT. 207
NEWTON MA
02464-1456
US

V. Phone/Fax

Practice location:
  • Phone: 857-364-4835
  • Fax: 857-364-4543
Mailing address:
  • Phone: 215-888-4840
  • Fax: 857-364-4543

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberSC005732
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number2378
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: