MEDICARE: RAMONA PANICI PHD LLC PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	PS1129	ME

General Provider Information

NPI Number	:	1811374523
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RAMONA PANICI PHD LLC PA

Provider Business Mailing Address
First Line	:	27 THUNDER RD
Second Line	:
City	:	NORTH YARMOUTH
State	:	ME
Zip	:	04097-6100
Country	:	US
Telephone Number	:	207-829-2152
Fax Number	:	844-839-4800

Provider Business Practice Location Address
First Line	:	27 THUNDER RD
Second Line	:
City	:	NORTH YARMOUTH
State	:	ME
Zip	:	04097-6100
Country	:	US
Telephone Number	:	207-829-2152
Fax Number	:	844-839-4800

Authorized Official
Title or Position	:	PSYCHOLOGIST
Name	:	RAMONA PANICI
Credential	:	PHD
Telephone Number	:	207-829-2152

Provider Enumeration Date	:	05/01/2015
Last Update Date	:	04/13/2016

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