Organization
COORDINATED PRIMARY CARE DBA HEALTHALLIANCE UROLOGY
Active
Parent organization
COORDINATED PRIMARY CARE
Organization subpart
Yes
Provider details
NPI number
Legal business name
COORDINATED PRIMARY CARE
Authorized official
PHYLLIS FABELLO (EXECUTIVE DIRECTOR)
(978) 466-4243
Entity
Organization
Contact information
Practice address
50 MEMORIAL DR, SUITE 207, LEOMINSTER, MA 01453-2238
(978) 466-2121
Mailing address
50 MEMORIAL DR, SUITE 207, LEOMINSTER, MA 01453-2238
(978) 466-2121
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9771476
—
MA
01
—
M20928
MEDICARE GROUP NUMBER
MA
Enumeration date
10/10/2008
Last updated
10/10/2008
Update your record
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