Provider Demographics
NPI:1033381702
Name:KITTERY FAMILY PRACTICE
Entity Type:Organization
Organization Name:KITTERY FAMILY PRACTICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:
Authorized Official - Last Name:LABONTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-351-2391
Mailing Address - Street 1:22 SHAPLEIGH RD
Mailing Address - Street 2:
Mailing Address - City:KITTERY
Mailing Address - State:ME
Mailing Address - Zip Code:03904-1455
Mailing Address - Country:US
Mailing Address - Phone:207-439-9430
Mailing Address - Fax:207-439-0968
Practice Address - Street 1:22 SHAPLEIGH RD
Practice Address - Street 2:
Practice Address - City:KITTERY
Practice Address - State:ME
Practice Address - Zip Code:03904-1455
Practice Address - Country:US
Practice Address - Phone:207-439-9430
Practice Address - Fax:207-439-0968
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:YORK HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-04-02
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes282N00000XHospitalsGeneral Acute Care Hospital
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty