# CITY OF PORTLAND MAINE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1437485117
- **Authorized official:** JON P. JENNINGS (CITY MANAGER)
- **Authorized official phone:** (207) 874-8944

## Contact information

- **Practice address:** 103 INDIA ST, PORTLAND, ME 04101-4211
- **Practice address phone:** (207) 874-8446
- **Practice address fax:** (207) 756-8087
- **Mailing address:** 389 CONGRESS ST, ROOM 307, PORTLAND, ME 04101-3566
- **Mailing address phone:** (207) 874-8784
- **Mailing address fax:** (207) 874-8913

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207KI0005X | Clinical & Laboratory Immunology (Allergy & Immunology) Physician | — | NULL | Yes |
| 207KI0005X | Clinical & Laboratory Immunology (Allergy & Immunology) Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/30/2009
- **Last updated:** 10/06/2015