NPIMap

Organization Active NPI

Brian D Tedesco, DPM & George a Abboud DPM PC

  • Podiatrist
  • Derry, NH
National Provider Identifier
1013771013
Registry record updated Feb 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
BRIAN D TEDESCO, DPM & GEORGE A ABBOUD DPM PC
Practice address
44 Birch St Ste 301
Derry, NH 03038-2752
Phone
(603) 260-6554
Fax
(603) 260-6559
NPI assigned
Feb 9, 2024
Last updated
Feb 9, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Sheila Antimone
Title
Office Manager
Phone
(781) 944-4044

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213E00000X Primary
Foot Surgery PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213ES0131X

Addresses

Primary practice location

44 Birch St Ste 301
Derry, NH 03038-2752

Mailing address

607 North Ave
Door 17, BLDG G
Wakefield, MA 01880-1303
Phone (781) 944-4044

National Provider Directory

National Provider Directory
Tax ID family
Brian D Tedesco DPM Georg5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

607 North Ave
Bldg G
Wakefield, MA 01880

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1707436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707436800000",
    "number": "1013771013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 NORTH AVE",
            "address_2": "DOOR 17, BLDG G",
            "city": "WAKEFIELD",
            "state": "MA",
            "postal_code": "018801303",
            "telephone_number": "781-944-4044",
            "fax_number": "781-944-4050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 BIRCH ST STE 301",
            "city": "DERRY",
            "state": "NH",
            "postal_code": "030382752",
            "telephone_number": "603-260-6554",
            "fax_number": "603-260-6559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIAN D TEDESCO, DPM & GEORGE A ABBOUD DPM PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-09",
        "last_updated": "2024-02-09",
        "certification_date": "2024-02-08",
        "status": "A",
        "authorized_official_last_name": "ANTIMONE",
        "authorized_official_first_name": "SHEILA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "781-944-4044"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Foot Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Derry, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.