Provider Demographics
NPI:1023175908
Name:PEDIATRIC SPECIALISTS OF FOXBOROUGH AND WRENTHAM
Entity type:Organization
Organization Name:PEDIATRIC SPECIALISTS OF FOXBOROUGH AND WRENTHAM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:A
Authorized Official - Last Name:GIULIANO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:508-543-6306
Mailing Address - Street 1:132 CENTRAL ST
Mailing Address - Street 2:SUITE 116
Mailing Address - City:FOXBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02035-2433
Mailing Address - Country:US
Mailing Address - Phone:508-543-6306
Mailing Address - Fax:508-543-2976
Practice Address - Street 1:132 CENTRAL ST
Practice Address - Street 2:SUITE 116
Practice Address - City:FOXBORO
Practice Address - State:MA
Practice Address - Zip Code:02035-2433
Practice Address - Country:US
Practice Address - Phone:508-543-6306
Practice Address - Fax:508-543-2976
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9769749Medicaid