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NPI Code Detail

MEDICARE: NORTH BRIDGE PODIATRY GROUP, P.C.

MEDICARE: NORTH BRIDGE PODIATRY GROUP, 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
1213EP1101XPrimary Podiatric Medicine PodiatristMA1967MA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1NOY77264OTHERMABLUE SHIELD OF MA
259939OTHERMAFALLON HEALTH PLAN
3667826OTHERMATUFTS HEALTH PLAN

General Provider Information

NPI Number : 1609831023
Entity Type Code : Organization
Provider Name (Legal Business Name) : NORTH BRIDGE PODIATRY GROUP, P.C.
Provider Business Mailing Address
First Line : 1732 MAIN ST
Second Line :
City : CONCORD
State : MA
Zip : 01742-3837
Country : US
Telephone Number : 978-369-2665
Fax Number : 978-371-9914
Provider Business Practice Location Address
First Line : 1732 MAIN ST
Second Line :
City : CONCORD
State : MA
Zip : 01742-3837
Country : US
Telephone Number : 978-369-2665
Fax Number : 978-371-9914
Authorized Official
Title or Position : OWNER
Name : GREGORY D. CATALANO
Credential : D.P.M.
Telephone Number : 978-369-2665
Provider Enumeration Date : 04/19/2006
Last Update Date : 03/25/2008

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Directions to “NORTH BRIDGE PODIATRY GROUP, P.C. ” Practice Location

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