Provider Demographics
NPI:1790326585
Name:PALUSZAK, REMIGIUSZ MARIUSZ (FNP)
Entity Type:Individual
Prefix:
First Name:REMIGIUSZ
Middle Name:MARIUSZ
Last Name:PALUSZAK
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 W BROADWAY
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-6064
Mailing Address - Country:US
Mailing Address - Phone:508-667-6825
Mailing Address - Fax:
Practice Address - Street 1:417 STATE ST #400, BANGOR, ME 04401
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:MA
Practice Address - Zip Code:04401-0440
Practice Address - Country:US
Practice Address - Phone:207-942-6096
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-02
Last Update Date:2022-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNP191209363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty