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NPI 1447332556

NPI 1447332556 : VALERIE S ATTIA PAC : BANGOR, ME

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General NPI Number Information
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    NPI Number           |    1447332556
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    Entity Type          |    Individual 
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    Provider Name        |    VALERIE S ATTIA PAC
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    10/19/2006
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    Last Update Date     |    07/16/2021
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Provider Practice Location Address
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    Address Line         |    78 RIDGEWOOD DR 
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    City                 |    BANGOR
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    State                |    ME
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    Zip                  |    04401-2652
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    Country              |    US
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    Telephone            |    207-307-8902
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    Fax                  |    207-307-8902
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Provider Business Mailing Address
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    Address Line         |    78 RIDGEWOOD DR 
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    City                 |    BANGOR
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    State                |    ME
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    Zip                  |    04401-2652
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    Country              |    US
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    Telephone            |    207-947-8381
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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        |    363A00000X
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    Taxonomy Name        |    Physician Assistant
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    License Number       |    PA001044
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    License Number State |    ME
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