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General NPI Number Information
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NPI Number | 1205814050
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Entity Type | Individual
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Provider Name | ANDREA TRUNCALI MD
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Gender | Female
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Dates
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Enumeration Date | 01/03/2006
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Last Update Date | 04/24/2025
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Provider Practice Location Address
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Address Line | 63 PREBLE ST
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City | PORTLAND
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State | ME
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Zip | 04101-3014
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Country | US
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Telephone | 207-874-2141
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Fax | 207-874-2164
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Provider Business Mailing Address
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Address Line | 180 PARK AVE
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City | PORTLAND
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State | ME
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Zip | 04102-2957
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Country | US
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Telephone | 207-874-2141
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Fax | 207-761-3738
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2083A0300X
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Taxonomy Name | Addiction Medicine (Preventive Medicine) Physician
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License Number | MD18940
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License Number State | ME
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Taxonomy #2
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Taxonomy Code | 2083P0500X
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Taxonomy Name | Preventive Medicine/Occupational Environmental Medicine Physician
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License Number | MD18940
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License Number State | ME
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 227001
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD18940
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License Number State | ME
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