Organization
DR. B CLINICAL NUTRITION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GINO BANCAYANVEGA ND MS CNS LDN (CEO)
(207) 271-0309
Entity
Organization
Contact information
Practice address
38 NORTH ST, MACHIAS, ME 04654-1123
(207) 271-0309
Mailing address
38 NORTH ST, MACHIAS, ME 04654-1123
(207) 271-0309
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
—
—
Other
Enumeration date
04/22/2026
Last updated
04/26/2026
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