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General NPI Number Information
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NPI Number | 1720370661
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Entity Type | Organization
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Legal Business Name | WESTBOROUGH PODIATRY PLLC
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Dates
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Enumeration Date | 05/11/2011
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Last Update Date | 05/11/2011
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Provider Practice Location Address
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Address Line | 45 LYMAN ST SUITE 10
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City | WESTBOROUGH
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State | MA
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Zip | 01581-2628
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Country | US
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Telephone | 508-836-0200
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Fax | 508-836-0282
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Provider Business Mailing Address
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Address Line | 45 LYMAN ST SUITE 10
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City | WESTBOROUGH
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State | MA
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Zip | 01581-2628
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Country | US
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Telephone | 508-836-0200
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Fax | 508-836-0282
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Authorized Official
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Title or Position | PRESIDENT
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Name | JAMES D KARADIMOS
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Credential | DPM
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Telephone | 508-836-0200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 1359
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License Number State | MA
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