Provider Demographics
NPI:1720370661
Name:WESTBOROUGH PODIATRY PLLC
Entity Type:Organization
Organization Name:WESTBOROUGH PODIATRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:D
Authorized Official - Last Name:KARADIMOS
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:508-836-0200
Mailing Address - Street 1:45 LYMAN ST
Mailing Address - Street 2:SUITE 10
Mailing Address - City:WESTBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01581-2628
Mailing Address - Country:US
Mailing Address - Phone:508-836-0200
Mailing Address - Fax:508-836-0282
Practice Address - Street 1:45 LYMAN ST
Practice Address - Street 2:SUITE 10
Practice Address - City:WESTBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01581-2628
Practice Address - Country:US
Practice Address - Phone:508-836-0200
Practice Address - Fax:508-836-0282
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-11
Last Update Date:2011-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1359213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty