Healthcare Provider Details

I. General information

NPI: 1114984606
Provider Name (Legal Business Name): CENTRAL MASSACHUSETTS PODIATRY, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2006
Last Update Date: 06/26/2023
Certification Date: 06/26/2023
Deactivation Date: 06/07/2023
Reactivation Date: 06/26/2023

III. Provider practice location address

299 LINCOLN ST SUITE 202
WORCESTER MA
01605-3646
US

IV. Provider business mailing address

299 LINCOLN ST STE 202
WORCESTER MA
01605-3646
US

V. Phone/Fax

Practice location:
  • Phone: 508-757-4003
  • Fax:
Mailing address:
  • Phone: 508-757-4003
  • Fax: 508-755-7592

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: DR. NEIL J FELDMAN
Title or Position: PRESIDENT/OWNER
Credential: DPM
Phone: 508-757-4003