| E. Merle Bragdon, Phd, Pa | |
|
178 Middle St Suite 300 Portland ME 04101-4075 | |
| (207) 772-1570 | |
| (207) 772-2670 |
| Full Name | E. Merle Bragdon, Phd, Pa |
|---|---|
| Speciality | Psychologist |
| Location | 178 Middle St, Portland, Maine |
| Authorized Official Name and Position | E Merle Bragdon (OWNER) |
| Authorized Official Contact | 2077721570 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| E. Merle Bragdon, Phd, Pa 178 Middle St Suite 300 Portland ME 04101-4075 Ph: (207) 772-1570 | E. Merle Bragdon, Phd, Pa 178 Middle St Suite 300 Portland ME 04101-4075 Ph: (207) 772-1570 |
| NPI Number | 1598069312 |
|---|---|
| Provider Enumeration Date | 01/09/2011 |
| Last Update Date | 01/09/2011 |
| Medicare PECOS PAC ID | 3678756012 |
|---|---|
| Medicare Enrollment ID | O20110323000368 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598069312 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PS742 (Maine) | Primary |
| 103TC0700X | Psychologist - Clinical | PS1124 (Maine) | Secondary |
| Provider Name | Elizabeth M Bragdon |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1659573731 PECOS PAC ID: 7214821107 Enrollment ID: I20040211000760 |
| Provider Name | Harold Longenecker |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1639313109 PECOS PAC ID: 9234312687 Enrollment ID: I20110323000460 |
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