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735 Washington Ave Portland ME 04103-4928 | |
| (207) 222-3021 | |
| (207) 536-0334 |
| Full Name | |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 735 Washington Ave, Portland, Maine |
| Authorized Official Name and Position | Alyson E. Maloy (PRESIDENT) |
| Authorized Official Contact | 2072223021 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
735 Washington Ave Portland ME 04103-4928 Ph: (207) 222-3021 | 735 Washington Ave Portland ME 04103-4928 Ph: (207) 222-3021 |
| NPI Number | 1851808356 |
|---|---|
| Provider Enumeration Date | 01/05/2018 |
| Last Update Date | 11/25/2024 |
| Certification Date | 11/22/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851808356 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | MD19147 (Maine) | Primary |
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