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General NPI Number Information
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NPI Number | 1528125663
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Entity Type | Organization
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Legal Business Name | CENTRAL MASSACHUSETTS FOOT SPECIALISTS INC.
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Dates
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Enumeration Date | 01/01/2007
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Last Update Date | 12/27/2010
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Provider Practice Location Address
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Address Line | 255 PARK AVE SUITE 803
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City | WORCESTER
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State | MA
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Zip | 01609-1953
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Country | US
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Telephone | 508-757-3803
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Fax | 508-757-8011
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Provider Business Mailing Address
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Address Line | 255 PARK AVE SUITE 803
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City | WORCESTER
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State | MA
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Zip | 01609-1953
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Country | US
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Telephone | 508-757-3803
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Fax | 508-757-8011
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Authorized Official
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Title or Position | PRESEIDENT
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Name | DR. ROBERT JOSEPH GREENE
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Credential | DPM
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Telephone | 508-757-3803
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number | 2121
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License Number State | MA
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