Individual
DR. SAMMY L PELLETIER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
764 ROUTE ONE, UNIT 6, YORK, ME 03909-5879
(207) 363-7555
(207) 363-1711
Mailing address
764 ROUTE ONE, UNIT 6, YORK, ME 03909-5879
(207) 363-7555
(207) 363-1711
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT729
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
018152
STAR #
ME
01
—
09Y000292ME01
BLUE CROSS PROVIDER #
ME
05
—
130570000
—
ME
01
—
2237986
AETNA PROV. #
ME
01
—
30009894
NH MEDICAID
ME
01
—
5021708
CIGNA PROVIDER #
ME
01
—
M22891
CIGNA PROVIDER #
ME
01
—
MM4138
MEDICARE
—
01
—
MNT038
HARVARD PILGRIM PROV. #
ME
Enumeration date
02/17/2006
Last updated
10/29/2015
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