Provider Demographics
NPI:1336426147
Name:COVENIENCE MEDICAL CENTER
Entity Type:Organization
Organization Name:COVENIENCE MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:F
Authorized Official - Last Name:ZAKARIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:508-864-7118
Mailing Address - Street 1:490 LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01605-1920
Mailing Address - Country:US
Mailing Address - Phone:508-864-7118
Mailing Address - Fax:
Practice Address - Street 1:490 LINCOLN ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01605-1920
Practice Address - Country:US
Practice Address - Phone:508-864-7118
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-08
Last Update Date:2011-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA227080207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty