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General NPI Number Information
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NPI Number | 1689524845
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Entity Type | Organization
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Legal Business Name | PINE TREE PSYCHIATRY
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Dates
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Enumeration Date | 01/29/2026
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Last Update Date | 02/04/2026
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Provider Practice Location Address
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Address Line | 16 MIDDLE ST FL 2
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City | PORTLAND
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State | ME
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Zip | 04101-5163
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Country | US
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Telephone | 207-791-6220
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Fax |
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Provider Business Mailing Address
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Address Line | 16 MIDDLE ST FL 2
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City | PORTLAND
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State | ME
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Zip | 04101-5163
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CO-OWNER
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Name | DR. CHIDRUP TRIPATHI
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Credential |
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Telephone | 207-791-6220
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2084P0805X
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Taxonomy Name | Geriatric Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2084F0202X
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Taxonomy Name | Forensic Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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