Organization · Type 2 NPI

Succor Primary Care Inc

Primary Care Nurse Practitioner · Waltham, MA

NPI number 1295311207 Active

Practice location

24 Crescent St Ste 407
Waltham, MA 02453-4309

Fax (781) 205-7602

Specialties and licenses

Taxonomy	Code	License
Primary Care Nurse Practitioner Primary	363LP2300X	None listed

Primary Care Nurse Practitioner: Definition to come...

NPI record

NPI: 1295311207
Entity type: Organization (Type 2)
Issued: Mar 20, 2021
Last updated: Mar 16, 2022
Status: Active

Other names

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Succor Primary Care, P.c · other name
Succor Primary Care, P.c · other name

Authorized official

Lelia Janice Magoba, NURSE PRACTITIONER
President
(781) 358-8633

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1295311207

Succor Primary Care Inc's National Provider Identifier is 1295311207, issued on Mar 20, 2021. The primary taxonomy on file is Primary Care Nurse Practitioner (363LP2300X), and the practice location is in Waltham, MA. The record was last updated on Mar 16, 2022.