Healthcare Provider Details

I. General information

NPI: 1467094706
Provider Name (Legal Business Name): KATRINA OJAKAAR CMF
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/08/2019
Last Update Date: 10/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 MAIN ST
YARMOUTH ME
04096-6745
US

IV. Provider business mailing address

15 STONY RIDGE RD
CUMBERLAND FORESIDE ME
04110-1416
US

V. Phone/Fax

Practice location:
  • Phone: 207-847-0675
  • Fax: 207-847-0687
Mailing address:
  • Phone: 408-219-0122
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224900000X
TaxonomyMastectomy Fitter
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: