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Organization
MAINEHEALTH
Active
Organization
MAINEHEALTH
Active
Parent organization
MAINEHEALTH
Other names
Maine Medical Partners Pediatric Specialty Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
MAINEHEALTH
Authorized official
LUGENE ANTHONY INZANA (ASSOCIATE CFO)
(207) 662-3538
Entity
Organization
Contact information
Practice address
887 CONGRESS ST, SUITE 320, PORTLAND, ME 04102
(207) 662-5522
(207) 662-5526
Mailing address
22 BRAMHALL ST, PORTLAND, ME 04102-3134
(207) 662-6562
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
NULL
1041C0700X
Clinical Social Worker
—
—
133V00000X
Registered Dietitian
—
NULL
133V00000X
Registered Dietitian
—
—
170300000X
Genetic Counselor (M.S.)
—
NULL
170300000X
Genetic Counselor (M.S.)
—
—
207RG0100X
Gastroenterology Physician
Primary
—
NULL
207RG0100X
Gastroenterology Physician
Primary
—
—
207SG0201X
Clinical Genetics (M.D.) Physician
—
NULL
207SG0201X
Clinical Genetics (M.D.) Physician
—
—
2080P0006X
Developmental - Behavioral Pediatrics Physician
—
NULL
2080P0006X
Developmental - Behavioral Pediatrics Physician
—
—
2080P0205X
Pediatric Endocrinology Physician
—
NULL
2080P0205X
Pediatric Endocrinology Physician
—
—
2080P0208X
Pediatric Infectious Diseases Physician
—
NULL
2080P0208X
Pediatric Infectious Diseases Physician
—
—
2080P0210X
Pediatric Nephrology Physician
—
NULL
2080P0210X
Pediatric Nephrology Physician
—
—
2080P0214X
Pediatric Pulmonology Physician
—
NULL
2080P0214X
Pediatric Pulmonology Physician
—
—
282N00000X
General Acute Care Hospital
37563
ME
363LF0000X
Family Nurse Practitioner
—
NULL
363LF0000X
Family Nurse Practitioner
—
—
363LP0200X
Pediatric Nurse Practitioner
—
NULL
363LP0200X
Pediatric Nurse Practitioner
—
—
Other
Enumeration date
02/25/2011
Last updated
12/19/2022
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