Altabtabaee, Russl

Altabtabaee, Russl is an individual health care provider with primary practice located at 55 Lake Ave N , Worcester MA 01655-0002. She recently has 2 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Podiatrist, Podiatric Medicine & Surgery Service Providers / Foot Surgery. Podiatric Medicine & Surgery Service Providers / Podiatrist is her primary health care specialty. Altabtabaee, Russl can be contacted via phone (508) 334-5500.

Contact Information

Primary practice address
55 Lake Ave N Worcester MA 01655-0002
Phone: (508) 334-5500
Fax: (508) 334-3408
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 59.000894 Ohio
Podiatric Medicine & Surgery Service Providers / Foot Surgery 213ES0131X PDF2560 Massachusetts
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X PDF2560 Massachusetts

Profile Details

NPI number 1528633096
LBN Legal business name Altabtabaee, Russl
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date May 26th, 2021
Last updated Sep 5th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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