Provider Demographics
NPI:1003843970
Name:CHARITON, JOEL T (DPM)
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:T
Last Name:CHARITON
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:999 NORTH MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:MA
Mailing Address - Zip Code:02368
Mailing Address - Country:US
Mailing Address - Phone:781-986-3668
Mailing Address - Fax:781-986-7604
Practice Address - Street 1:999 NORTH MAIN STREET
Practice Address - Street 2:
Practice Address - City:RANDOLPH
Practice Address - State:MA
Practice Address - Zip Code:02368
Practice Address - Country:US
Practice Address - Phone:781-986-3668
Practice Address - Fax:781-986-7604
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-27
Last Update Date:2011-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1914213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
2704329OtherUNITED HEALTHCARE DIRECT
33710OtherHPHC
B20293301OtherCIGNA
2148117OtherAETNA US HEALTHCARE
MA00362875Medicaid
2700317OtherUNITED HEALTHCARE
7166069OtherTUFTS
33710OtherHPHC
B20293301OtherCIGNA
MAY70911Medicare UPIN