Provider Demographics
NPI:1043370497
Name:A R AMALFITANO, DO
Entity Type:Organization
Organization Name:A R AMALFITANO, DO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER AND PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:AMALFITANO
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:207-873-0644
Mailing Address - Street 1:PO BOX 298
Mailing Address - Street 2:
Mailing Address - City:WATERVILLE
Mailing Address - State:ME
Mailing Address - Zip Code:04903-0298
Mailing Address - Country:US
Mailing Address - Phone:207-873-0644
Mailing Address - Fax:207-873-6749
Practice Address - Street 1:94 SILVER ST
Practice Address - Street 2:
Practice Address - City:WATERVILLE
Practice Address - State:ME
Practice Address - Zip Code:04901-5924
Practice Address - Country:US
Practice Address - Phone:207-873-0644
Practice Address - Fax:207-873-6749
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-08
Last Update Date:2008-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty