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General NPI Number Information
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NPI Number | 1548358302
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Entity Type | Organization
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Legal Business Name | CASCO BAY REHABILITATION, PA
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Dates
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Enumeration Date | 10/10/2006
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Last Update Date | 03/23/2015
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Provider Practice Location Address
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Address Line | 335 BRIGHTON AVE
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City | PORTLAND
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State | ME
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Zip | 04102-2363
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Country | US
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Telephone | 207-829-6009
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Fax | 207-829-6022
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Provider Business Mailing Address
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Address Line | 335 BRIGHTON AVE
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City | PORTLAND
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State | ME
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Zip | 04102-2363
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Country | US
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Telephone | 207-829-6009
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Fax | 207-829-6022
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Authorized Official
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Title or Position | MD
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Name | SYED KAZMI
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Credential | MD
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Telephone | 207-829-6009
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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