Provider Demographics
NPI:1821089079
Name:NORWOOD PODIATRY ASSOCIATES PC
Entity Type:Organization
Organization Name:NORWOOD PODIATRY ASSOCIATES PC
Other - Org Name:NPA CAPE ANN FOOT AND ANKLE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:DIMAMBRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-762-4205
Mailing Address - Street 1:480 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:NORWOOD
Mailing Address - State:MA
Mailing Address - Zip Code:02062-2347
Mailing Address - Country:US
Mailing Address - Phone:781-762-4205
Mailing Address - Fax:781-255-7905
Practice Address - Street 1:24 WALPOLE ST FL 1
Practice Address - Street 2:
Practice Address - City:NORWOOD
Practice Address - State:MA
Practice Address - Zip Code:02062-3356
Practice Address - Country:US
Practice Address - Phone:781-762-4205
Practice Address - Fax:781-255-7905
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-04
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1496213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9722904Medicaid
MAY77057OtherBC/BS
MA=========OtherTAX ID
MA=========OtherTAX ID
MAY77057OtherBC/BS