Provider Demographics
NPI:1174191837
Name:ESSEX COUNTY PRIMARY CARE
Entity Type:Organization
Organization Name:ESSEX COUNTY PRIMARY CARE
Other - Org Name:ESSEX COUNTY PRIMARY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:AVGERINOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:978-233-8120
Mailing Address - Street 1:42 ASBURY ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH HAMILTON
Mailing Address - State:MA
Mailing Address - Zip Code:01982-1808
Mailing Address - Country:US
Mailing Address - Phone:978-233-8120
Mailing Address - Fax:
Practice Address - Street 1:42 ASBURY ST
Practice Address - Street 2:
Practice Address - City:SOUTH HAMILTON
Practice Address - State:MA
Practice Address - Zip Code:01982-1808
Practice Address - Country:US
Practice Address - Phone:978-233-8120
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-17
Last Update Date:2021-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty