Provider Demographics
NPI:1285856435
Name:NORTH SHORE PODIARTY ASSOCIATES, INC.
Entity Type:Organization
Organization Name:NORTH SHORE PODIARTY ASSOCIATES, INC.
Other - Org Name:FOOT CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ELIOT
Authorized Official - Middle Name:G
Authorized Official - Last Name:SHERR
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:978-531-4484
Mailing Address - Street 1:205 ANDOVER ST
Mailing Address - Street 2:ROUTE 114
Mailing Address - City:PEABODY
Mailing Address - State:MA
Mailing Address - Zip Code:01960-1603
Mailing Address - Country:US
Mailing Address - Phone:978-531-4484
Mailing Address - Fax:978-531-0289
Practice Address - Street 1:205 ANDOVER STREET
Practice Address - Street 2:
Practice Address - City:PEABODY
Practice Address - State:MA
Practice Address - Zip Code:01960-1603
Practice Address - Country:US
Practice Address - Phone:978-531-4484
Practice Address - Fax:978-531-0289
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2008-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1497213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA33525OtherHARVARD PILGRIM
MA3893662-001OtherCIGNA
MA329545OtherUNITED HEALTHCARE
MA00023184OtherNEIGHBORHOOD HEALTHCARE
MAY70620OtherBCBS
MA795250OtherTUFTS
MA33525OtherHARVARD PILGRIM
MA3893662-001OtherCIGNA
MAY70620OtherBCBS