Mendeszoon, Ewald Ray

Mendeszoon, Ewald Ray is an individual health care provider with primary practice located at 732 Harrison Avenue Preston 5Th Floor, Boston MA 02118. He 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 / Foot Surgery is his primary health care specialty. Mendeszoon, Ewald Ray can be contacted via phone (617) 414-6840.

Contact Information

Primary practice address
732 Harrison Avenue Preston 5Th Floor Boston MA 02118
Phone: (617) 414-6840
Fax: (617) 414-6710
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 2092 Massachusetts
Podiatric Medicine & Surgery Service Providers / Foot Surgery 213ES0131X 2092 Massachusetts

Profile Details

NPI number 1528031952
LBN Legal business name Mendeszoon, Ewald Ray
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 8th, 2006
Last updated Sep 28th, 2017 - about 7 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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Identifiers

StateTypeNumberIssuer
All States NPI 1528031952 NPPES
Massachusetts MEDICAID 110013015A

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