Atlantic Primary Care, Pc | |
135 Webster St Hanover MA 02339-1200 | |
(781) 871-5030 | |
(781) 871-5480 |
Full Name | Atlantic Primary Care, Pc |
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Speciality | Clinic/Center |
Location | 135 Webster St, Hanover, Massachusetts |
Authorized Official Name and Position | Nahid B Kennedy (PRESIDENT) |
Authorized Official Contact | 7818715030 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Atlantic Primary Care, Pc Po Box 2302 Hanover MA 02339-8301 Ph: (781) 871-5030 | Atlantic Primary Care, Pc 135 Webster St Hanover MA 02339-1200 Ph: (781) 871-5030 |
NPI Number | 1326015454 |
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Provider Enumeration Date | 03/07/2006 |
Last Update Date | 09/01/2011 |
Medicare PECOS PAC ID | 5496787707 |
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Medicare Enrollment ID | O20050908000111 |
Identifier | Type | State | Issuer |
---|---|---|---|
1326015454 | NPI | - | NPPES |
3142540 | Medicaid | MA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | 79640 (Massachusetts) | Primary |
Provider Name | Nahid B Kennedy |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1871561597 PECOS PAC ID: 9436180262 Enrollment ID: I20050822001113 |
Provider Name | Carissa Marie Kelly |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1821307646 PECOS PAC ID: 2264627132 Enrollment ID: I20101117001009 |
Provider Name | Imane Ouahidi |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1548999600 PECOS PAC ID: 0042687477 Enrollment ID: I20221027002478 |
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