Healthcare Provider Details

I. General information

NPI: 1659794709
Provider Name (Legal Business Name): MICHAEL FOOTE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2014
Last Update Date: 10/02/2023
Certification Date: 10/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 E 66TH ST
NEW YORK NY
10065-6800
US

IV. Provider business mailing address

75 FRANCIS STREET BWH, INTERNAL MEDICINE
BOSTON MA
02115
US

V. Phone/Fax

Practice location:
  • Phone: 646-888-5261
  • Fax: 929-321-7326
Mailing address:
  • Phone: 617-732-6660
  • Fax: 617-975-0985

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number297623-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: