Provider Demographics
NPI:1962475392
Name:AFFILIATES IN FOOT CARE, PC
Entity type:Organization
Organization Name:AFFILIATES IN FOOT CARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:C
Authorized Official - Last Name:PAICOS
Authorized Official - Suffix:JR
Authorized Official - Credentials:DPM
Authorized Official - Phone:781-979-0919
Mailing Address - Street 1:3 WOODLAND RD
Mailing Address - Street 2:SUITE 411
Mailing Address - City:STONEHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02180-1702
Mailing Address - Country:US
Mailing Address - Phone:781-979-0919
Mailing Address - Fax:781-979-0334
Practice Address - Street 1:3 WOODLAND RD
Practice Address - Street 2:SUITE 411
Practice Address - City:STONEHAM
Practice Address - State:MA
Practice Address - Zip Code:02180-1702
Practice Address - Country:US
Practice Address - Phone:781-979-0919
Practice Address - Fax:781-979-0334
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-08
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1860213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA67220OtherHEALTH SOURCE
MA002200OtherTUFTS INDIVIDUAL
MA87831OtherAETNA
MA7820474OtherAETNA
MAB20539501OtherCIGNA
MA2704470OtherHEALTHCARE VALUE MGMT
MA33199OtherHARVARD PILGRIM
MA334202OtherHARVARD PILGRIM
MA720289OtherTUFTS GROUP
MA710674OtherTUFTS INDIVIDUAL
MA0506940001Medicare NSC
MA002200OtherTUFTS INDIVIDUAL
MA2704470OtherHEALTHCARE VALUE MGMT
MA33199OtherHARVARD PILGRIM
MAY70874Medicare ID - Type UnspecifiedMEDICARE INDIVIDUAL
MAP00036252Medicare ID - Type UnspecifiedRR MEDICARE
MA480015085Medicare ID - Type UnspecifiedRR MEDICARE
MAY75129Medicare ID - Type UnspecifiedMEDICARE INDIVIDUAL