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General NPI Number Information
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NPI Number | 1295855948
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Entity Type | Organization
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Legal Business Name | MAINE EYE CENTER, PA
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Dates
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Enumeration Date | 03/29/2007
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Last Update Date | 10/12/2023
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Provider Practice Location Address
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Address Line | 161 MARGINAL WAY
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City | PORTLAND
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State | ME
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Zip | 04101-2438
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Country | US
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Telephone | 207-774-8277
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Fax | 207-699-5850
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Provider Business Mailing Address
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Address Line | 15 LOWELL ST
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City | PORTLAND
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State | ME
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Zip | 04102-2726
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Country | US
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Telephone | 207-774-8277
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Fax | 207-699-5850
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Authorized Official
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Title or Position | DIRECTOR OF REVENUE CYCLE
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Name | JUDITH MCCANN
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Credential |
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Telephone | 848-219-2109
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | 36641
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License Number State | ME
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