Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 2103 | MA |
Y | 222Z00000X | Podiatrist | 2103 | MA |
N | 213EP1101X | Primary Podiatric Medicine | 2103 | MA |
N | 213ES0131X | Foot Surgery | 2103 | MA |
NPI | 1427142322 |
---|---|
Provider Name | Dr. Sharon Lynne Treston-Magnacca |
First Address | Milford, MA 01757-2131 |
Second Address | Milford, MA 01757-2131 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2006 |
Last Update Date | 23/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
Y75115 | (02) | MA |