Dr Jerrold C Edelberg, PHD | |
280b Gannett Dr, South Portland, ME 04106-6940 | |
(207) 828-0048 | |
(207) 772-3743 |
Full Name | Dr Jerrold C Edelberg |
---|---|
Gender | Male |
Speciality | Psychologist - Clinical |
Location | 280b Gannett Dr, South Portland, Maine |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1619203973 | NPI | - | NPPES |
1053467779 | Medicaid | ME |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103TC0700X | Psychologist - Clinical | PS561 (Maine) | Primary |
Entity Name | Port Resources |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1053467779 PECOS PAC ID: 5496078206 Enrollment ID: O20150102000068 |
Mailing Address | Practice Location Address |
---|---|
Dr Jerrold C Edelberg, PHD 280b Gannett Dr, South Portland, ME 04106-6940 Ph: (207) 828-0048 | Dr Jerrold C Edelberg, PHD 280b Gannett Dr, South Portland, ME 04106-6940 Ph: (207) 828-0048 |
Dr. Kimberly Christine Drouin, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 609 Main St, Suite 3, South Portland, ME 04106 Phone: 207-775-2220 Fax: 207-775-2226 | |
Dr. Brittani J Berbette, PHD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 41 Donald B Dean Dr Ste A, South Portland, ME 04106 Phone: 207-661-6064 | |
Dr. Gabriel Mauricio Garza Sada, PH.D. Psychologist Medicare: Medicare Enrolled Practice Location: 707 Sable Oaks Dr Ste 230, South Portland, ME 04106 Phone: 603-883-0005 | |
Dr. Jonathan David Birnberg, PH.D. Psychologist Medicare: Accepting Medicare Assignments Practice Location: 609 Main St, Suite 3, South Portland, ME 04106 Phone: 207-775-2220 Fax: 207-775-2226 | |
Dr. Christine Joan Cooke, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 837 Broadway, South Portland, ME 04106 Phone: 207-332-3872 | |
Dr. Carole Orem-hough, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 837 Broadway, South Portland, ME 04106 Phone: 207-775-0600 Fax: 207-799-0852 | |
Mr. Patron Nkurunziza Bazoza, MD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 586 Westbrook St, South Portland, ME 04106 Phone: 325-518-5324 |