Healthcare Provider Details
I. General information
NPI: 1538154869
Provider Name (Legal Business Name): COMMUNITY PHYSICIANS ASSOCIATES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/13/2005
Last Update Date: 04/16/2025
Certification Date: 04/16/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
92 HIGHLAND ST
MILTON MA
02186-3800
US
IV. Provider business mailing address
32 S MAIN ST SUITE 100
RANDOLPH MA
02368-4835
US
V. Phone/Fax
- Phone: 617-696-4600
- Fax: 781-986-0058
- Phone: 781-986-6078
- Fax: 781-986-0058
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RP1001X |
| Taxonomy | Pulmonary Disease Physician |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SHEILAH
RANGAVIZ
Title or Position: CFO
Credential:
Phone: 617-313-1350