Provider Demographics
NPI:1467251322
Name:MITCHELL J WACHTEL DPM PC
Entity type:Organization
Organization Name:MITCHELL J WACHTEL DPM PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MITCHELL
Authorized Official - Middle Name:
Authorized Official - Last Name:WACHTEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-794-8406
Mailing Address - Street 1:451 ANDOVER ST STE 202
Mailing Address - Street 2:
Mailing Address - City:NORTH ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01845-5069
Mailing Address - Country:US
Mailing Address - Phone:978-794-8406
Mailing Address - Fax:
Practice Address - Street 1:451 ANDOVER ST STE 202
Practice Address - Street 2:
Practice Address - City:NORTH ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01845-5069
Practice Address - Country:US
Practice Address - Phone:978-794-8406
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MITCHELL J WACHTEL DPM PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-03-12
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty