Provider Demographics
NPI:1578312344
Name:COMPREHENSIVE PRIMARY ALLCARE INC
Entity type:Organization
Organization Name:COMPREHENSIVE PRIMARY ALLCARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:MONICAH
Authorized Official - Middle Name:W
Authorized Official - Last Name:KAGUNGO
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:781-413-7505
Mailing Address - Street 1:49 BLANCHARD ST STE 205-7
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01843-1454
Mailing Address - Country:US
Mailing Address - Phone:781-583-1355
Mailing Address - Fax:781-358-0770
Practice Address - Street 1:49 BLANCHARD ST STE 205-7
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01843-1454
Practice Address - Country:US
Practice Address - Phone:781-583-1355
Practice Address - Fax:781-358-0770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-15
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty