Provider Demographics
NPI:1477562676
Name:COMEAU, ANJA MARY (NP)
Entity Type:Individual
Prefix:
First Name:ANJA
Middle Name:MARY
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:SEACOAST AFFILIATED GROUP PRACTICE INC
Mailing Address - Street 2:24 MORRILL PLACE
Mailing Address - City:AMESBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01913-3530
Mailing Address - Country:US
Mailing Address - Phone:978-834-8074
Mailing Address - Fax:
Practice Address - Street 1:LAHEY CLINIC
Practice Address - Street 2:41 MALL ROAD
Practice Address - City:BURLINGTON
Practice Address - State:MA
Practice Address - Zip Code:01805-0001
Practice Address - Country:US
Practice Address - Phone:781-744-5100
Practice Address - Fax:781-744-5215
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2022-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA204476207R00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0376621Medicaid
MA0376621Medicaid
MANP2823Medicare ID - Type Unspecified