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General NPI Number Information
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NPI Number | 1316072283
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Entity Type | Organization
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Legal Business Name | COORDINATED PRIMARY CARE
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Dates
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Enumeration Date | 02/22/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 50 MEMORIAL DR SUITE 114
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City | LEOMINSTER
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State | MA
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Zip | 01453-2238
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Country | US
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Telephone | 978-466-4980
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Fax | 978-466-4985
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Provider Business Mailing Address
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Address Line | 50 MEMORIAL DR SUITE 114
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City | LEOMINSTER
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State | MA
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Zip | 01453-2238
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Country | US
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Telephone | 978-466-4980
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Fax | 978-466-4985
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Authorized Official
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Title or Position | CFO
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Name | MR. MICHAEL CAFONE
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Credential |
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Telephone | 978-466-2000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 222879
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License Number State | MA
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