Healthcare Provider Details

I. General information

NPI: 1982624094
Provider Name (Legal Business Name): VALERIE M O'HARA DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: VALERIE M. ROSSIGNOL DO

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

119 NORTHPORT AVE FL 2
BELFAST ME
04915-6069
US

IV. Provider business mailing address

119 NORTHPORT AVE FL 2
BELFAST ME
04915-6069
US

V. Phone/Fax

Practice location:
  • Phone: 207-505-4970
  • Fax: 207-618-5563
Mailing address:
  • Phone: 207-505-4970
  • Fax: 207-618-5563

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080B0002X
TaxonomyPediatric Obesity Medicine Physician
License NumberDO1629
License Number StateME
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberDO1629
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: