Provider Demographics
NPI:1760480131
Name:COMEAU, PARRY N (PT, DC)
Entity Type:Individual
Prefix:DR
First Name:PARRY
Middle Name:N
Last Name:COMEAU
Suffix:
Gender:M
Credentials:PT, DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 CONIFER HILL DR. STE 205
Mailing Address - Street 2:
Mailing Address - City:DANVERS
Mailing Address - State:MA
Mailing Address - Zip Code:01923-1166
Mailing Address - Country:US
Mailing Address - Phone:978-774-5600
Mailing Address - Fax:978-774-5601
Practice Address - Street 1:100 CONIFER HILL DR.
Practice Address - Street 2:STE 205
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923-1166
Practice Address - Country:US
Practice Address - Phone:978-774-5600
Practice Address - Fax:978-774-5601
Is Sole Proprietor?:No
Enumeration Date:2005-07-11
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2218111N00000X
NY014739225100000X
MA9751225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110012948AMedicaid
MA0310263Medicaid
MAY36541OtherMEDICARE D.C.
MAY36541OtherMEDICARE D.C.