MEDICARE: DR. DOMINICK GARIBALDI DPM

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	213EP1101X	Primary Podiatric Medicine Podiatrist	1786	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0037250	OTHER	MA	NEIGHBORHOOD HEALTH PLAN
2	0972475	OTHER	MA	CIGNA
3	33595	OTHER	MA	HARVARD PILGIM HEALTH CAR
4	0093909	OTHER	MA	AETNA USHC
5	Y70802	OTHER	MA	BLUE SHEILD OF MA
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	99448201	OTHER	MA	NETWORK HEALTH
8	715076	OTHER	MA	TUFTS HEALTH PLAN

General Provider Information

NPI Number	:	1457341257
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DOMINICK GARIBALDI DPM

Provider Business Mailing Address
First Line	:	2 CHAMBERLAIN AVE UNIT 2
Second Line	:	STE 2
City	:	WINTHROP
State	:	MA
Zip	:	02152-1021
Country	:	US
Telephone Number	:	617-846-2609
Fax Number	:	617-846-3513

Provider Business Practice Location Address
First Line	:	2 CHAMBERLAIN AVE UNIT 2
Second Line	:	SUITE 2
City	:	WINTHROP
State	:	MA
Zip	:	02152-1021
Country	:	US
Telephone Number	:	617-846-2609
Fax Number	:	617-846-3513

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/24/2005
Last Update Date	:	05/20/2013

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