Organization
FAMILY FOOT CARE GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES W CONNOLLY JR. DPM (PRESIDENT)
(781) 593-1700
Entity
Organization
Contact information
Practice address
990 PARADISE RD, SUITE 1B, SWAMPSCOTT, MA 01907-1395
(781) 593-1700
(617) 776-3850
Mailing address
56 OCEAN AVE, SALEM, MA 01970-4627
(781) 593-1700
(617) 776-3850
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
600634
TUFTS HEALTH PLAN
MA
05
—
9760482
—
MA
01
—
Y77123
BLUE SHIELD OF MA
MA
Enumeration date
07/05/2007
Last updated
12/07/2016
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