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) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
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
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All providers in Salem, MA · Family Medicine Physician in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 1, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.