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General NPI Number Information
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NPI Number | 1043467343
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Entity Type | Organization
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Legal Business Name | MEMCARE LLC
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Dates
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Enumeration Date | 08/19/2008
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Last Update Date | 08/19/2008
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Provider Practice Location Address
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Address Line | 27 JUNE ST THIRD FLOOR
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City | SANFORD
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State | ME
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Zip | 04073-2621
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Country | US
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Telephone | 207-490-0900
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Fax | 207-490-0902
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Provider Business Mailing Address
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Address Line | 187 OLD STAGE RD
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City | SANBORNVILLE
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State | NH
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Zip | 03872-4627
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Country | US
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Telephone | 603-522-9412
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Fax | 603-522-3234
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SANDEEP SOBTI
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Credential | M.D.
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Telephone | 603-522-9412
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0805X
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Taxonomy Name | Geriatric Psychiatry Physician
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License Number | 17566
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License Number State | ME
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