Provider Demographics
NPI:1013956309
Name:GIURINI, JOHN M (DPM)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:M
Last Name:GIURINI
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:185 PILGRIM RD
Mailing Address - Street 2:DIVISION OF PODIATRY
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-5324
Mailing Address - Country:US
Mailing Address - Phone:617-632-7071
Mailing Address - Fax:617-632-7085
Practice Address - Street 1:185 PILGRIM RD
Practice Address - Street 2:DIVISION OF PODIATRY
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-5324
Practice Address - Country:US
Practice Address - Phone:617-632-7071
Practice Address - Fax:617-632-7085
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2008-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1690213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0362247Medicaid
MA1690OtherPODIATRY LICENSE
MA1690OtherPODIATRY LICENSE