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Organization
ALICORN INC
Active
Organization
ALICORN INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PRAVEEN MOOGANUR (CEO)
(202) 276-3074
Entity
Organization
Contact information
Practice address
63 1/2 JEFFERSON AVE, SALEM, MA 01970-2975
(202) 276-3074
Mailing address
3401 ANNANDALE RD, FALLS CHURCH, VA 22042-3502
(202) 276-3074
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
07/01/2022
Last updated
07/01/2022
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