Provider Demographics
NPI:1164450979
Name:COMEAU, EILEEN (NP)
Entity Type:Individual
Prefix:
First Name:EILEEN
Middle Name:
Last Name:COMEAU
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:362 N BEDFORD ST
Mailing Address - Street 2:
Mailing Address - City:EAST BRIDGEWATER
Mailing Address - State:MA
Mailing Address - Zip Code:02333-1148
Mailing Address - Country:US
Mailing Address - Phone:508-350-2350
Mailing Address - Fax:508-350-2318
Practice Address - Street 1:1 COMPASS WAY
Practice Address - Street 2:SUITE 102
Practice Address - City:EAST BRIDGEWATER
Practice Address - State:MA
Practice Address - Zip Code:02333-1465
Practice Address - Country:US
Practice Address - Phone:508-350-2100
Practice Address - Fax:508-350-2314
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2015-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA212950363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
UX1843OtherMEDICARE PTAN
MANP429502OtherMEDICARE
UX1843OtherMEDICARE PTAN