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General NPI Number Information
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NPI Number | 1982651733
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Entity Type | Organization
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Legal Business Name | BOSTON COMMON PODIATRY INC
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Dates
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Enumeration Date | 05/27/2006
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Last Update Date | 09/03/2013
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Provider Practice Location Address
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Address Line | 264 BEACON ST SUTIE 201
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City | BOSTON
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State | MA
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Zip | 02116-1236
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Country | US
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Telephone | 617-262-2266
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Fax |
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Provider Business Mailing Address
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Address Line | 264 BEACON ST SUITE 201
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City | BOSTON
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State | MA
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Zip | 02116-1236
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Country | US
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Telephone | 617-262-2266
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JORDANA SZPIRO
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Credential | D.P.M.
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Telephone | 617-973-6799
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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 |
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License Number State |
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