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General NPI Number Information
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NPI Number | 1427011568
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Entity Type | Individual
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Provider Name | PETER ANTHONY GUILFOYLE PA-C
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Gender | Male
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Dates
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Enumeration Date | 04/10/2006
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Last Update Date | 10/06/2023
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Provider Practice Location Address
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Address Line | 19 S GORHAM XING
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City | GORHAM
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State | ME
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Zip | 04038-2690
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Country | US
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Telephone | 207-535-1400
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Fax |
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Provider Business Mailing Address
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Address Line | 655 MAIN ST
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City | SACO
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State | ME
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Zip | 04072-1699
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Country | US
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Telephone | 207-294-5600
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Fax |
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 104-0000105
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License Number State | VT
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 055.0031165
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License Number State | VT
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA1400
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License Number State | ME
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