Healthcare Provider Details

I. General information

NPI: 1649430893
Provider Name (Legal Business Name): JENNIFER PALMINTERI AGREN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNIFER M PALMINTERI MD

II. Dates (important events)

Enumeration Date: 06/11/2008
Last Update Date: 11/04/2025
Certification Date: 11/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 FODEN ROAD SUITE 103
SOUTH PORTLAND ME
04106-2351
US

IV. Provider business mailing address

100 FODEN ROAD SUITE 103
SOUTH PORTLAND ME
04106-2351
US

V. Phone/Fax

Practice location:
  • Phone: 207-828-1122
  • Fax:
Mailing address:
  • Phone: 207-828-1122
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD18894
License Number StateME
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberMD18894
License Number StateME
# 3
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberMD18894
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: