Healthcare Provider Details

I. General information

NPI: 1063059111
Provider Name (Legal Business Name): HARBOR PEDIATRICS, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2019
Last Update Date: 04/15/2022
Certification Date: 04/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 BRICKYARD LN UNIT B
YORK ME
03909-1686
US

IV. Provider business mailing address

1 BRICKYARD LN STE B
YORK ME
03909-1686
US

V. Phone/Fax

Practice location:
  • Phone: 207-606-2032
  • Fax: 207-606-2039
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. KYLA SCARPONI
Title or Position: OWNER
Credential: DO
Phone: 207-606-2032