Healthcare Provider Details

I. General information

NPI: 1962591271
Provider Name (Legal Business Name): ROBERT CIANFARANO RPA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 WATERVILLE COMMONS STE. 1A
WATERVILLE ME
04901
US

IV. Provider business mailing address

360 US HIGHWAY 1 BYP UNIT 102
PORTSMOUTH NH
03801-7105
US

V. Phone/Fax

Practice location:
  • Phone: 207-352-2720
  • Fax: 207-352-2196
Mailing address:
  • Phone: 603-410-6700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number010885-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA-251
License Number StateME
# 3
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA1203
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: