Provider Demographics
NPI:1598228124
Name:NEW ENGLAND FAMILY FOOT CARE, INC.
Entity type:Organization
Organization Name:NEW ENGLAND FAMILY FOOT CARE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:RICCI
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:617-698-4830
Mailing Address - Street 1:100 HIGHLAND ST STE 122
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:MA
Mailing Address - Zip Code:02186-3878
Mailing Address - Country:US
Mailing Address - Phone:617-698-4830
Mailing Address - Fax:617-698-3668
Practice Address - Street 1:100 HIGHLAND ST STE 122
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:MA
Practice Address - Zip Code:02186-3878
Practice Address - Country:US
Practice Address - Phone:617-698-4830
Practice Address - Fax:617-698-3668
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-10
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110154951AMedicaid