| Small Potatoes, Pa | |
|
1 Front St Bath ME 04530-2562 | |
| (207) 725-4778 | |
| Not Available |
| Full Name | Small Potatoes, Pa |
|---|---|
| Speciality | Social Worker |
| Location | 1 Front St, Bath, Maine |
| Authorized Official Name and Position | Michaelanne Rosenzweig (PRESIDENT) |
| Authorized Official Contact | 2077254778 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Small Potatoes, Pa 19 Signature Dr Brunswick ME 04011-1753 Ph: (207) 725-4778 | Small Potatoes, Pa 1 Front St Bath ME 04530-2562 Ph: (207) 725-4778 |
| NPI Number | 1477730646 |
|---|---|
| Provider Enumeration Date | 01/29/2008 |
| Last Update Date | 01/29/2008 |
| Medicare PECOS PAC ID | 7012090889 |
|---|---|
| Medicare Enrollment ID | O20160321001191 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477730646 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Michaelanne Rosenzweig |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699716993 PECOS PAC ID: 9032154067 Enrollment ID: I20050621000715 |
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