Provider Demographics
NPI:1972647824
Name:ALLERGY & ASTHMA ASSOCIATES OF MAINE
Entity Type:Organization
Organization Name:ALLERGY & ASTHMA ASSOCIATES OF MAINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-774-9839
Mailing Address - Street 1:195 FORE RIVER PKWY
Mailing Address - Street 2:SUITE 410
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04102-2780
Mailing Address - Country:US
Mailing Address - Phone:207-774-9839
Mailing Address - Fax:
Practice Address - Street 1:195 FORE RIVER PKWY
Practice Address - Street 2:SUITE 410
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04102-2780
Practice Address - Country:US
Practice Address - Phone:207-774-9839
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-16
Last Update Date:2015-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME133546Medicare ID - Type Unspecified
ME1972647824Medicare NSC