Provider Demographics
NPI:1720025018
Name:COMEAU HEALTH CARE ASSOCIATES PC
Entity Type:Organization
Organization Name:COMEAU HEALTH CARE ASSOCIATES PC
Other - Org Name:COMEAU REHAB THERAPIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLERK
Authorized Official - Prefix:DR
Authorized Official - First Name:PARRY
Authorized Official - Middle Name:N
Authorized Official - Last Name:COMEAU
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DC
Authorized Official - Phone:978-774-5600
Mailing Address - Street 1:194 NORTH ST
Mailing Address - Street 2:
Mailing Address - City:DANVERS
Mailing Address - State:MA
Mailing Address - Zip Code:01923-1242
Mailing Address - Country:US
Mailing Address - Phone:978-774-5600
Mailing Address - Fax:978-774-5601
Practice Address - Street 1:194 NORTH ST
Practice Address - Street 2:
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923-1242
Practice Address - Country:US
Practice Address - Phone:978-774-5600
Practice Address - Fax:978-774-5601
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMEAU HEALTH CARE ASSOCIATES PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-02
Last Update Date:2011-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0310263Medicaid
MA0310263Medicaid