Provider Demographics
NPI:1629615828
Name:CENTER FOR MORTONS NEUROMA LLC
Entity Type:Organization
Organization Name:CENTER FOR MORTONS NEUROMA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:AUGUSTE
Authorized Official - Last Name:BEDET
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-665-4344
Mailing Address - Street 1:600 WORCESTER RD STE 301
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01702-5316
Mailing Address - Country:US
Mailing Address - Phone:508-665-4344
Mailing Address - Fax:508-665-4355
Practice Address - Street 1:600 WORCESTER RD STE 301
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702-5316
Practice Address - Country:US
Practice Address - Phone:508-665-4344
Practice Address - Fax:508-665-4355
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-06
Last Update Date:2019-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Multi-Specialty