Provider Demographics
NPI:1174256374
Name:FOOT SPECIALISTS OF NEW ENGLAND PLLC
Entity Type:Organization
Organization Name:FOOT SPECIALISTS OF NEW ENGLAND PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:A
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:JR
Authorized Official - Credentials:DPM
Authorized Official - Phone:817-516-4700
Mailing Address - Street 1:20 HOPE AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02453-2717
Mailing Address - Country:US
Mailing Address - Phone:781-516-4700
Mailing Address - Fax:781-701-0550
Practice Address - Street 1:449 ROUTE 130 STE 5
Practice Address - Street 2:
Practice Address - City:SANDWICH
Practice Address - State:MA
Practice Address - Zip Code:02563-2339
Practice Address - Country:US
Practice Address - Phone:508-888-8338
Practice Address - Fax:617-773-4301
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FOOT SPECIALISTS OF NEW ENGLAND PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-07-05
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric MedicineGroup - Multi-Specialty
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty
No213ES0000XPodiatric Medicine & Surgery Service ProvidersPodiatristSports MedicineGroup - Multi-Specialty
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Multi-Specialty
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Multi-Specialty