Provider Demographics
NPI:1134268188
Name:ASSOCIATES IN PODIATRY PC
Entity type:Organization
Organization Name:ASSOCIATES IN PODIATRY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:G
Authorized Official - Last Name:CARMODY
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:802-773-7151
Mailing Address - Street 1:69 ALLEN ST STE 5
Mailing Address - Street 2:
Mailing Address - City:RUTLAND
Mailing Address - State:VT
Mailing Address - Zip Code:05701-4564
Mailing Address - Country:US
Mailing Address - Phone:802-773-7151
Mailing Address - Fax:802-775-0679
Practice Address - Street 1:69 ALLEN ST
Practice Address - Street 2:SUITE 8
Practice Address - City:RUTLAND
Practice Address - State:VT
Practice Address - Zip Code:05701-4564
Practice Address - Country:US
Practice Address - Phone:802-773-7151
Practice Address - Fax:802-775-0679
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT560000146213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT0VN0870Medicaid
19597OtherBCBS
VTOVN0870Medicaid
VN0351Medicare ID - Type Unspecified