Healthcare Provider Details

I. General information

NPI: 1427399906
Provider Name (Legal Business Name): MAYRA A. TORRES BRINK PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MAYRA A. BRINK PA

II. Dates (important events)

Enumeration Date: 03/08/2013
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 SHUMAN AVE STE 6
AUGUSTA ME
04330-6020
US

IV. Provider business mailing address

12 SHUMAN AVE STE 6
AUGUSTA ME
04330-6020
US

V. Phone/Fax

Practice location:
  • Phone: 207-307-0958
  • Fax: 207-512-5909
Mailing address:
  • Phone: 207-307-0958
  • Fax: 207-512-5909

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA319
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: