| Alicorn Inc | |
|
63 1/2 Jefferson Ave Salem MA 01970-2975 | |
| (202) 276-3074 | |
| Not Available |
| Full Name | Alicorn Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 63 1/2 Jefferson Ave, Salem, Massachusetts |
| Authorized Official Name and Position | Praveen Mooganur (CEO) |
| Authorized Official Contact | 2022763074 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Alicorn Inc 3401 Annandale Rd Falls Church VA 22042-3502 Ph: (202) 276-3074 | Alicorn Inc 63 1/2 Jefferson Ave Salem MA 01970-2975 Ph: (202) 276-3074 |
| NPI Number | 1285367706 |
|---|---|
| Provider Enumeration Date | 07/01/2022 |
| Last Update Date | 07/01/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285367706 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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