Provider Demographics
NPI:1326493297
Name:ROY, JEFFY
Entity Type:Individual
Prefix:
First Name:JEFFY
Middle Name:
Last Name:ROY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 UNICORN PARK DR STE 3
Mailing Address - Street 2:
Mailing Address - City:WOBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01801-3339
Mailing Address - Country:US
Mailing Address - Phone:781-979-0919
Mailing Address - Fax:
Practice Address - Street 1:100 UNICORN PARK DR STE 3
Practice Address - Street 2:
Practice Address - City:WOBURN
Practice Address - State:MA
Practice Address - Zip Code:01801-3339
Practice Address - Country:US
Practice Address - Phone:781-979-0919
Practice Address - Fax:781-979-0334
Is Sole Proprietor?:No
Enumeration Date:2016-04-28
Last Update Date:2019-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2482213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery