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Individual
DR. JAMES JOHN DIRESTA
Active
Individual
DR. JAMES JOHN DIRESTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM, MPH
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
1523
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
702862
TAHP
MA
01
—
Y70643
BLUE SHIELD
MA
Enumeration date
06/02/2006
Last updated
10/22/2015
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