Provider Demographics
NPI:1942272760
Name:CRAIG-COMIN, ROBERT E (MSW)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:E
Last Name:CRAIG-COMIN
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4175
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01810-0813
Mailing Address - Country:US
Mailing Address - Phone:978-749-2720
Mailing Address - Fax:978-470-0804
Practice Address - Street 1:565 TURNPIKE ST
Practice Address - Street 2:SUITE #81
Practice Address - City:N ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01845-5922
Practice Address - Country:US
Practice Address - Phone:978-749-2720
Practice Address - Fax:978-470-0804
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-06
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1062381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAPO4433Medicare UPIN
MAPO4433Medicare ID - Type Unspecified
MA256926Medicare UPIN
MA401576Medicare UPIN