Individual
JEFFREY G PREVITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
818 CONGRESS ST, PORTLAND, ME 04102-3112
(207) 773-8161
Mailing address
19 EVERETT ST, MELROSE, MA 02176-4513
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
07/07/2017
Last updated
07/07/2017
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