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General NPI Number Information
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NPI Number | 1750002812
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Entity Type | Organization
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Legal Business Name | PRIMARY PREVENTION CENTER PLLC
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Dates
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Enumeration Date | 09/07/2022
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Last Update Date | 05/08/2023
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Provider Practice Location Address
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Address Line | 638 NEWTOWN YARDLEY RD
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City | NEWTOWN
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State | PA
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Zip | 18940-1758
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Country | US
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Telephone | 484-619-0512
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Fax |
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Provider Business Mailing Address
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Address Line | 811 WESTRIDGE DR
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City | PHOENIXVILLE
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State | PA
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Zip | 19460-3365
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Country | US
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Telephone | 484-619-0512
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MICHAEL RICHARD COMO
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Credential | CRNP
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Telephone | 484-619-0512
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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