NPI 1649577768

Mainehealth

Organisation Otolaryngology Physician Portland, ME

Practice location

Address: 1250 Forest Ave, Portland, ME 04103
Phone: (207) 797-5753
Fax: (207) 797-9571
Mailing address: 22 Bramhall St, Portland, ME 04102-3134

Authorised official

Name: Lugene Anthony Inzana
Title: Associate Cfo
Phone: (207) 662-3538

Registered specialties (4)

Otolaryngology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207Y00000X

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Audiologist

Speech, Language and Hearing Service Providers Taxonomy 231H00000X

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General Acute Care Hospital

Hospitals Taxonomy 282N00000X Licence 37563 (ME)

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Medical Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363AM0700X

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Registry record

NPI: 1649577768
Entity type: Organization
NPI issued: 25 Feb 2011
Record last updated: 19 Dec 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.