Organization
BAYSIDE EMPLOYEE HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JANE GLASS DO (OWNER PHYSIATRIST)
(207) 780-6631
Entity
Organization
Contact information
Practice address
323 MARGINAL WAY, PORTLAND, ME 04101-2543
(207) 780-6631
(207) 780-6320
Mailing address
323 MARGINAL WAY, PO BOX 697, PORTLAND, ME 04101-2543
(207) 780-6631
(207) 780-6320
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
013905
ME
305S00000X
Point of Service
Primary
1249
ME
305S00000X
Point of Service
PA-042
ME
Other
Enumeration date
11/22/2006
Last updated
08/22/2020
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