Provider Demographics
NPI:1710078712
Name:FOOT HEALTH INC
Entity Type:Organization
Organization Name:FOOT HEALTH INC
Other - Org Name:MARSHALL M TAITZ
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DPM
Authorized Official - Prefix:DR
Authorized Official - First Name:MARSHALL
Authorized Official - Middle Name:M
Authorized Official - Last Name:TAITZ
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:508-674-1400
Mailing Address - Street 1:75 NEWMAN AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:RUMFORD
Mailing Address - State:RI
Mailing Address - Zip Code:02916
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:164 DURFEE ST
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02720
Practice Address - Country:US
Practice Address - Phone:508-674-1400
Practice Address - Fax:508-673-2146
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-27
Last Update Date:2013-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAMA1574213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA001574OtherTUFTS
MA1819138OtherCIGNA
MA5819OtherNEIGHBORHOOD HEALTH
RI402653OtherBLUE CHIP
RI7072OtherBLUE CROSS OF RI
MA33034OtherHARVARD PILGRIM
MA9778594Medicaid
MAY77154OtherBLUE CROSS
MA9778594Medicaid
MALX0150Medicare PIN
MA1819138OtherCIGNA
MAY70668Medicare PIN
RI7072OtherBLUE CROSS OF RI