Doctor Name: | DR. STEPHEN PATRICK TUBRIDY |
NPI Number: | 1104840974 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | D.P.M. |
License Number: | 1906 |
Business Practice Address: | 1244 Boylston St Suite 101 Chestnut Hill, MA - 024672116 |
Business Phone Number: | 6172321752 |
Business Fax Number: | 6175661919 |
Mailing Address: | 1244 Boylston St, Suite 101 CHESTNUT HILL |
State: | MA |
Postal Code: | 024672116 |
Phone Number: | 6172321752 |
Fax Number: | 6175661919 |
NPI Enumeration Date: | 07/26/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213ES0131X |
License Number: | 1906 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Foot Surgery |
Taxonomy Definition: |