Organization
YORK FAMILY PRACTICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN M JENDZEJEC DO (PRESIDENT)
(207) 363-8430
Entity
Organization
Contact information
Practice address
16 HOSPITAL DRIVE, YORK, ME 03909
(207) 363-8430
(207) 351-3006
Mailing address
16 HOSPITAL DRIVE, YORK, ME 03909
(207) 363-8430
(207) 351-3006
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
596163
AETNA HMO
—
01
—
C19364
RAILROAD MEDICARE
—
01
—
MM4006
MEDICARE B
—
01
—
YORK083565
ANTHEM BCBS NEW HAMPSHIRE
—
Enumeration date
01/10/2007
Last updated
04/20/2008
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