| Maine Geriatrics | |
|
22 W Cole Rd Ste 101 Biddeford ME 04005-9431 | |
| (207) 780-6565 | |
| (207) 878-6565 |
| Full Name | Maine Geriatrics |
|---|---|
| Speciality | Internal Medicine |
| Location | 22 W Cole Rd Ste 101, Biddeford, Maine |
| Authorized Official Name and Position | Jabbar Fazeli (PRESIDENT/OWNER) |
| Authorized Official Contact | 2077806565 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Maine Geriatrics 22 W Cole Rd Ste 101 Biddeford ME 04005-9431 Ph: (207) 780-6565 | Maine Geriatrics 22 W Cole Rd Ste 101 Biddeford ME 04005-9431 Ph: (207) 780-6565 |
| NPI Number | 1326156605 |
|---|---|
| Provider Enumeration Date | 08/28/2006 |
| Last Update Date | 10/15/2021 |
| Medicare PECOS PAC ID | 8224427570 |
|---|---|
| Medicare Enrollment ID | O20211108002613 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326156605 | NPI | - | NPPES |
| 227900000 | Medicaid | ME |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0300X | Internal Medicine - Geriatric Medicine | (* (Not Available)) | Primary |
| Provider Name | Jabbar Fazeli |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1649363805 PECOS PAC ID: 1456327980 Enrollment ID: I20040907001000 |
| Provider Name | Shannon C Munro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295828499 PECOS PAC ID: 4688609472 Enrollment ID: I20050929001157 |
| Provider Name | Amy Elise Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689345902 PECOS PAC ID: 2466840483 Enrollment ID: I20211025002077 |
| Provider Name | Kathryn P Desrosiers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164103958 PECOS PAC ID: 7214384163 Enrollment ID: I20231114002711 |
| Provider Name | Halee R Storey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073393435 PECOS PAC ID: 1951748805 Enrollment ID: I20240327001630 |
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