Provider Demographics
NPI:1053491696
Name:KAPLAN, JONATHAN DAVID (DPM)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:DAVID
Last Name:KAPLAN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:65 WALNUT ST
Mailing Address - Street 2:SUITE 360
Mailing Address - City:WELLESLEY
Mailing Address - State:MA
Mailing Address - Zip Code:02481-2118
Mailing Address - Country:US
Mailing Address - Phone:781-416-3668
Mailing Address - Fax:781-431-8637
Practice Address - Street 1:65 WALNUT ST
Practice Address - Street 2:SUITE 360
Practice Address - City:WELLESLEY
Practice Address - State:MA
Practice Address - Zip Code:02481-2118
Practice Address - Country:US
Practice Address - Phone:781-416-3668
Practice Address - Fax:781-431-8637
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2016-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA001901213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MALX0453OtherPTAN
T87752Medicare UPIN
MALX0453OtherPTAN