Provider Demographics
NPI:1134844079
Name:NEEDHAM FOOT DOCTORS, P.C.
Entity type:Organization
Organization Name:NEEDHAM FOOT DOCTORS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:M
Authorized Official - Last Name:RUTOWICZ
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:781-883-6907
Mailing Address - Street 1:145 ROSEMARY ST STE B
Mailing Address - Street 2:
Mailing Address - City:NEEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02494-3259
Mailing Address - Country:US
Mailing Address - Phone:781-444-1129
Mailing Address - Fax:781-444-3666
Practice Address - Street 1:145 ROSEMARY ST STE B
Practice Address - Street 2:
Practice Address - City:NEEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02494-3259
Practice Address - Country:US
Practice Address - Phone:781-444-1129
Practice Address - Fax:781-444-3666
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-04
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty