MEDICARE: VALLEY PODIATRY ASSOCIATES PC

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	213E00000X	Podiatrist	1786	MA

General Provider Information

NPI Number	:	1861721300
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VALLEY PODIATRY ASSOCIATES PC

Provider Business Mailing Address
First Line	:	PO BOX 10417
Second Line	:
City	:	HOLYOKE
State	:	MA
Zip	:	01041-2017
Country	:	US
Telephone Number	:	413-540-0150
Fax Number	:	413-540-0159

Provider Business Practice Location Address
First Line	:	95 POST OFFICE PARK
Second Line	:	SUITE 9525
City	:	WILBRAHAM
State	:	MA
Zip	:	01095-1248
Country	:	US
Telephone Number	:	413-682-0031
Fax Number	:	413-682-0040

Authorized Official
Title or Position	:	OWNER
Name	:	WALTER WOLF
Credential	:	DMP
Telephone Number	:	413-682-0031

Provider Enumeration Date	:	12/11/2009
Last Update Date	:	05/16/2019

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