Provider Demographics
NPI:1508045667
Name:ACHILLES PODIATRY PLLC
Entity Type:Organization
Organization Name:ACHILLES PODIATRY PLLC
Other - Org Name:STEVEN A. ROTHSTEIN DPM
Other - Org Type:Other Name
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:A
Authorized Official - Last Name:ROTHSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:603-641-8637
Mailing Address - Street 1:384 WILSON ST
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03103-4912
Mailing Address - Country:US
Mailing Address - Phone:603-641-8637
Mailing Address - Fax:603-641-2143
Practice Address - Street 1:384 WILSON ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03103-4912
Practice Address - Country:US
Practice Address - Phone:603-641-8637
Practice Address - Fax:603-641-2143
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-25
Last Update Date:2007-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH159213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30363701Medicaid
NH30363701Medicaid
NHRE8170Medicare PIN
NH4933760001Medicare NSC