Provider Demographics
NPI:1467096701
Name:BOARD CERTIFIED FOOTCARE LLC
Entity Type:Organization
Organization Name:BOARD CERTIFIED FOOTCARE LLC
Other - Org Name:PAULA ANGELINI, DPM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCLAUGHLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-226-8070
Mailing Address - Street 1:140 PARK ST STE 1
Mailing Address - Street 2:
Mailing Address - City:ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02703-8048
Mailing Address - Country:US
Mailing Address - Phone:508-226-8070
Mailing Address - Fax:
Practice Address - Street 1:77 TURNPIKE RD
Practice Address - Street 2:
Practice Address - City:SOUTHBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01772-2110
Practice Address - Country:US
Practice Address - Phone:508-226-8070
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-30
Last Update Date:2022-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty