Healthcare Provider Details

I. General information

NPI: 1790120913
Provider Name (Legal Business Name): KATHERINE KOOT D.P.M.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2013
Last Update Date: 12/01/2025
Certification Date: 12/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 WEST ST
MILFORD MA
01757-2200
US

IV. Provider business mailing address

430 WINCHESTER ST
NEWTON MA
02461-2011
US

V. Phone/Fax

Practice location:
  • Phone: 508-473-2273
  • Fax:
Mailing address:
  • Phone: 508-473-2273
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License Number2442
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number2442
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: