Provider Demographics
NPI:1447279617
Name:NEW ENGLAND COMPREHENSIVE FOOT & ANKLE GROUP, LLC
Entity type:Organization
Organization Name:NEW ENGLAND COMPREHENSIVE FOOT & ANKLE GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YENA
Authorized Official - Middle Name:HOANG
Authorized Official - Last Name:DO
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:305-975-5800
Mailing Address - Street 1:2211 MASSACHUSETTS AVE
Mailing Address - Street 2:SUITE1
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02140-1211
Mailing Address - Country:US
Mailing Address - Phone:617-821-6329
Mailing Address - Fax:617-354-3877
Practice Address - Street 1:2211 MASSACHUSETTS AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02140-1211
Practice Address - Country:US
Practice Address - Phone:617-821-6329
Practice Address - Fax:617-354-3877
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-19
Last Update Date:2011-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2217213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA7347225OtherCIGNA HEALTHCARE
MA90539OtherFALLON COMMUNITY HEALTH
MA95995101OtherNETWORK HEALTH
MAAA69029OtherHARVARD PILGRIM
MA1447279617OtherNETWORK HEALTH PLAN
MA1447279617OtherNEIGHBORHOOD HEALTH PLAN
MA649085OtherTUFTS
MA9746820Medicaid
MA7626827OtherAETNA
MAAA96300OtherHARVARD PILGRIM
MAY77361OtherBLUE CROSS BLUE SHIELD
MA9746820Medicaid
MAAA69029OtherHARVARD PILGRIM
MA90539OtherFALLON COMMUNITY HEALTH
MA=========OtherGREAT-WEST HEALTHCARE