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NPI Code Detail

MEDICARE: MS. LORRAINE LALIBERTE PAC

MEDICARE: MS. LORRAINE LALIBERTE PAC
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
1363A00000XPhysician AssistantPA457ME

General Provider Information

NPI Number : 1982673638
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. LORRAINE LALIBERTE PAC
Provider Business Mailing Address
First Line : 100 GANNETT DRIVE
Second Line : STE C
City : SOUTH PORTLAND
State : ME
Zip : 04106
Country : US
Telephone Number : 207-347-2947
Fax Number : 207-874-2317
Provider Business Practice Location Address
First Line : 84 MARGINAL WAY
Second Line : SUITE 700
City : PORTLAND
State : ME
Zip : 04101-2443
Country : US
Telephone Number : 207-774-5816
Fax Number : 207-523-8597
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/15/2006
Last Update Date : 03/06/2026

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Directions to “ MS. LORRAINE LALIBERTE PAC” Practice Location

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