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Contact Information

RUSSL ALTABTABAEE, DPM
55 LAKE AVE N
WORCESTER, MA01655-0002
 Phone: 508-334-5500
 Fax: 508-334-3408
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Podiatrist

213E00000X 48 Podiatry
 

Surgery, Foot

213ES0131X 48 Podiatry
Indicates primary specialty

NPI Profile & details for RUSSL ALTABTABAEE · (Female)

NPI Number 1528633096
Status Active
Credentials DPM (Doctor of Podiatric Medicine)
Entity Individual
Enumeration date 05/26/2021
Last updated 09/05/2024 - More than a year ago
Sole proprietor 1 No
Identifiers
  • MA License # PDF2560
  • OH License # 59.000894
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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