Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 1914 | MA |
Y | 222Z00000X | Podiatrist | 1914 | MA |
NPI | 1003843970 |
---|---|
Provider Name | Joel T Chariton |
First Address | Randolph, MA 02368 |
Second Address | Randolph, MA 02368 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2006 |
Last Update Date | 27/06/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00362875 | (05) | MA |
2148117 | AETNA US HEALTHCARE (01) | |
2700317 | UNITED HEALTHCARE (01) | |
2704329 | UNITED HEALTHCARE DIRECT (01) | |
33710 | HPHC (01) | |
7166069 | TUFTS (01) | |
B20293301 | CIGNA (01) | |
T90425 | (02) | |
Y70911 | (02) | MA |