Provider Demographics
NPI:1891120887
Name:NEW ENGLAND TELEMEDICINE PA
Entity Type:Organization
Organization Name:NEW ENGLAND TELEMEDICINE PA
Other - Org Name:PARAMOUNT MEDICAL SUPPLY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:TRUSTIN
Authorized Official - Middle Name:ROY
Authorized Official - Last Name:ENNACHERIL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:617-780-8110
Mailing Address - Street 1:98 ROUTE 236
Mailing Address - Street 2:SUITE #1
Mailing Address - City:KITTERY
Mailing Address - State:ME
Mailing Address - Zip Code:03904
Mailing Address - Country:US
Mailing Address - Phone:855-275-9962
Mailing Address - Fax:207-703-2781
Practice Address - Street 1:98 ROUTE 236
Practice Address - Street 2:SUITE #1
Practice Address - City:KITTERY
Practice Address - State:ME
Practice Address - Zip Code:03904
Practice Address - Country:US
Practice Address - Phone:855-275-9962
Practice Address - Fax:207-703-2781
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-09
Last Update Date:2013-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No335E00000XSuppliersProsthetic/Orthotic Supplier