Organization
BANGOR INTEGRATIVE HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEONA CERKOVITZ FNP (OWNER/PROVIDER)
(207) 866-9025
Entity
Organization
Contact information
Practice address
192 PARK ST, ORONO, ME 04473-4602
(207) 866-9025
(207) 866-2207
Mailing address
192 PARK ST, ORONO, ME 04473-4602
(207) 866-9025
(207) 866-2207
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
038985
ME
363LF0000X
Family Nurse Practitioner
Primary
038985
ME
Other
Enumeration date
08/20/2006
Last updated
06/22/2009
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