# MAINEHEALTH

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Parent organization:** MAINEHEALTH
- **Other names:** Maine Medical Partners Pediatric Specialty Care
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1477850592
- **Legal business name:** MAINEHEALTH
- **Authorized official:** LUGENE ANTHONY INZANA (ASSOCIATE CFO)
- **Authorized official phone:** (207) 662-3538

## Contact information

- **Practice address:** 887 CONGRESS ST, SUITE 320, PORTLAND, ME 04102
- **Practice address phone:** (207) 662-5522
- **Practice address fax:** (207) 662-5526
- **Mailing address:** 22 BRAMHALL ST, PORTLAND, ME 04102-3134
- **Mailing address phone:** (207) 662-6562

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 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 | — | NULL | Yes |
| 207RG0100X | Gastroenterology Physician | — | — | Yes |
| 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