Alicorn Inc

Organization Active NPI Family Medicine Physician · Salem, MA

NPI 1285367706 · NPPES record last updated Jul 1, 2022

Key facts

NPI
1285367706
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
Legal business name
ALICORN INC
Practice address
63 1/2 Jefferson Ave
Salem, MA 01970-2975
Phone
(202) 276-3074
NPI assigned
Jul 1, 2022
Organization subpart
No

Authorized official

Name
Praveen Mooganur
Title
Ceo
Phone
(202) 276-3074

National Provider Directory

Locations

63 Jefferson Ave
Salem, MA 01970
Phone (202) 276-3074

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207Q00000X Yes

Addresses

Primary practice location

63 1/2 Jefferson Ave
Salem, MA 01970-2975

Mailing address

3401 Annandale Rd
Falls Church, VA 22042-3502
Phone (202) 276-3074

Other providers in Salem, MA

All providers in Salem, MA · Family Medicine Physician in Massachusetts

Sources for this page

Verify at the official NPI Registry.