Provider Demographics
NPI:1689228108
Name:BOARD CERTIFIED FOOTCARE,LLC
Entity Type:Organization
Organization Name:BOARD CERTIFIED FOOTCARE,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LEAD PODIATRIST
Authorized Official - Prefix:
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:F
Authorized Official - Last Name:ANGELINI
Authorized Official - Suffix:
Authorized Official - Credentials:DPM, FACFAS
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
Mailing Address - Country:US
Mailing Address - Phone:508-226-8070
Mailing Address - Fax:
Practice Address - Street 1:140 PARK ST STE 1
Practice Address - Street 2:
Practice Address - City:ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02703
Practice Address - Country:US
Practice Address - Phone:508-226-8070
Practice Address - Fax:508-223-3498
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-01
Last Update Date:2022-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty