Provider Demographics
NPI:1669257812
Name:ALLARACARE MEDICAL GROUP - NEWBURYPORT, LLC
Entity type:Organization
Organization Name:ALLARACARE MEDICAL GROUP - NEWBURYPORT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:
Authorized Official - Last Name:ELLIOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-774-2555
Mailing Address - Street 1:147 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MIDDLETON
Mailing Address - State:MA
Mailing Address - Zip Code:01949-2446
Mailing Address - Country:US
Mailing Address - Phone:978-828-1416
Mailing Address - Fax:
Practice Address - Street 1:147 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MIDDLETON
Practice Address - State:MA
Practice Address - Zip Code:01949-2446
Practice Address - Country:US
Practice Address - Phone:978-828-1416
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-28
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care