Provider Demographics
NPI:1316538374
Name:CENTRAL MASSACHUSETTS PODIATRY, PC
Entity Type:Organization
Organization Name:CENTRAL MASSACHUSETTS PODIATRY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NEIL
Authorized Official - Middle Name:J
Authorized Official - Last Name:FELDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:508-757-4003
Mailing Address - Street 1:299 LINCOLN ST STE 202
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01605-3646
Mailing Address - Country:US
Mailing Address - Phone:508-757-4003
Mailing Address - Fax:508-755-7592
Practice Address - Street 1:24 LYMAN ST STE 180
Practice Address - Street 2:
Practice Address - City:WESTBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01581-1483
Practice Address - Country:US
Practice Address - Phone:508-757-4003
Practice Address - Fax:508-755-7592
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-01
Last Update Date:2023-06-26
Deactivation Date:2023-06-07
Deactivation Code:
Reactivation Date:2023-06-26
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty