Provider Demographics
NPI:1346544475
Name:COMEAU, GLORIA JEAN
Entity Type:Individual
Prefix:MS
First Name:GLORIA
Middle Name:JEAN
Last Name:COMEAU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 LENOX ST
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04073-3209
Mailing Address - Country:US
Mailing Address - Phone:207-329-4212
Mailing Address - Fax:
Practice Address - Street 1:51 LENOX ST
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:ME
Practice Address - Zip Code:04073-3209
Practice Address - Country:US
Practice Address - Phone:207-329-4212
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-04
Last Update Date:2011-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide