Provider Demographics
NPI:1053460543
Name:AFFILIATES IN PODIATRY PC
Entity Type:Organization
Organization Name:AFFILIATES IN PODIATRY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HARRY
Authorized Official - Middle Name:Z
Authorized Official - Last Name:PAPAZIAN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:617-924-5282
Mailing Address - Street 1:303 MOUNT AUBURN ST
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02472-1956
Mailing Address - Country:US
Mailing Address - Phone:617-924-5282
Mailing Address - Fax:617-926-5317
Practice Address - Street 1:303 MOUNT AUBURN ST
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:MA
Practice Address - Zip Code:02472-1956
Practice Address - Country:US
Practice Address - Phone:617-924-5282
Practice Address - Fax:617-926-5317
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-10
Last Update Date:2013-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1411213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA708357OtherTUFTS HEALTH PLAN
MAY70683OtherBCBS MA
MA702456OtherTUFTS HEALTH PLAN
MA1427136613OtherMEDICARE NPI
MA1528043510OtherMEDICARE NPI
MA001612OtherTUFTS HEALTH PLAN
MA001612OtherTUFTS HEALTH PLAN
MA702456OtherTUFTS HEALTH PLAN
MAT58718Medicare UPIN
MA6288070002Medicare NSC
MAY70546Medicare PIN