MEDICARE: NEEDHAM PODIATRY P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0103X	Foot & Ankle Surgery Podiatrist	2069	MA

General Provider Information

NPI Number	:	1114113503
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEEDHAM PODIATRY P.C.

Provider Business Mailing Address
First Line	:	464 HILLSIDE AVE STE 302
Second Line	:
City	:	NEEDHAM
State	:	MA
Zip	:	02494-1228
Country	:	US
Telephone Number	:	781-444-1129
Fax Number	:	781-444-3666

Provider Business Practice Location Address
First Line	:	464 HILLSIDE AVE STE 302
Second Line	:
City	:	NEEDHAM
State	:	MA
Zip	:	02494-1228
Country	:	US
Telephone Number	:	781-444-1129
Fax Number	:	781-444-3666

Authorized Official
Title or Position	:	PODIATRIST
Name	:	DR. DANIEL M RUTOWICZ
Credential	:	DPM
Telephone Number	:	781-444-1129

Provider Enumeration Date	:	09/19/2007
Last Update Date	:	11/18/2025

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