NORTHEAST NEPHROLOGY PA (NPI# 1336145200) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336145200 |
| Entity Type | Organization |
| Organization Name | NORTHEAST NEPHROLOGY PA |
| Practice Address |
417 State St Ste 321 Bangor ME 04401-6638 |
| Practice Telephone | 2079738833 |
| Practice Fax Number | 2079738836 |
| Mailing Telephone | 2079738833 |
| Mailing Fax Number | 2079738836 |
| Enumeration Date | 2005-06-24 |
| Last Update Date | 2010-05-04 |
| Authorized Official Name | STEPHEN G COMEAU (PRESIDENT) |
| Authorized Official Telephone | 2079738833 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RN0300X |
Internal Medicine Specialization: Nephrology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ME | 132020000 | 05 |
| Street Address |
417 STATE ST STE 321 |
| City | BANGOR |
| State | ME |
| Zip Code | 04401-6638 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295731131 | David Lawrence Levy | Internal Medicine | 417 State St, Ste 321, Bangor, ME 04401-6638 | 2005-06-24 |
| 1891304473 | Kristina Lynn Leonard | Nurse Practitioner | 417 State St, Bangor, ME 04401-6630 | 2020-07-29 |
| 1528558830 | Kelli Megan Nicole Huth | Physician Assistant | 417 State St, Bangor, ME 04401-6630 | 2018-05-11 |
| 1770005670 | Caitlin Dombrowski | Psychologist | 417 State St, Bangor, ME 04401 | 2017-07-12 |
| 1497281844 | Jamie Hight | Physician Assistant | 417 State St, Webber East Suite 221, Bangor, ME 04401-6630 | 2017-05-04 |
| 1255871240 | Courtney Lee Taylor | Nurse Practitioner | 417 State St, Webber East, Suite 421, Bangor, ME 04401-6630 | 2017-02-24 |
| 1083153977 | Tyler Munro | Physician Assistant | 417 State St, Suite 340, Bangor, ME 04401 | 2017-02-13 |
| 1457802530 | Carmen Jean Van Dusen | Nurse Practitioner | 417 State St, Suite 330, Bangor, ME 04401-6630 | 2016-10-24 |
| 1992187199 | Erin Borges | Physician Assistant | 417 State St, Webber West Suite 340, Bangor, ME 04401-6630 | 2015-06-24 |
| 1750789897 | Dahl Chase Diagnostic Services | Clinical Medical Laboratory | 417 State St, Suite 440, Bangor, ME 04401-6630 | 2014-12-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184222523 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 110 Longview Dr, Bangor, ME 04401 | 2020-10-16 |
| 1033737937 | Daniel John Phulman | Counselor | 202 Exchange Street, Bangor, ME 04401 | 2020-07-08 |
| 1770104358 | Elizabeth Sarah Caruson | Physician Assistant | 417 State Street Webber Medical Building, East St, Ste. 121, Bangor, ME 04401 | 2020-05-05 |
| 1053961300 | Erika Dean | Occupational Therapist | 84 Sylvan Rd., Bangor, ME 04401 | 2019-09-18 |
| 1942853635 | Wildworks Therapy, Pllc | Occupational Therapist | 123 Mt Hope Ave, Bangor, ME 04401 | 2019-07-22 |
| 1255999173 | Jessica Arbisi | Physician Assistant | 1 Northeast Drive, Bangor, ME 04401 | 2019-06-05 |
| 1699232041 | Ehab Khamis Elhefnawi | Anesthesiology | Emmc Anesthesia Professional Service, 489 State Street, Bangor, ME 04401 | 2019-02-21 |
| 1477028884 | Zvorufura Makura | Otolaryngology | 885 Union Street, Ste 145, Bangor, ME 04401 | 2018-10-11 |
| 1255826541 | Lindsey M Fields | Optometrist | 955 Broadway Eye Center Northeast Dba Northeast Eyecare, Bangor, ME 04401 | 2018-06-28 |
| 1992211338 | Debra J Mcintyre | Counselor | 157 Park Street, #5, Bangor, ME 04401 | 2017-12-21 |
| Find all providers in zip 04401 | ||||
| Taxonomy Code | 207RN0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Nephrology |
| An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295731131 | David Lawrence Levy | Internal Medicine | 417 State St, Ste 321, Bangor, ME 04401-6638 | 2005-06-24 |
| 1982862751 | Manish Nepal | Internal Medicine | 417 State St, Suite 321, Bangor, ME 04401-6630 | 2008-05-29 |
| 1194906859 | Mihail Ion Soare | Internal Medicine | 417 State St, Suite 321, Bangor, ME 04401-6630 | 2007-11-21 |
| 1225258213 | Richard A Patch | Internal Medicine | 417 State St, Suite 321 Webber Building, Bangor, ME 04401-6613 | 2007-05-01 |
| 1285749085 | Michael C Mcgoldrick | Internal Medicine | 417 State St, Suite 321, Bangor, ME 04401 | 2006-08-20 |
| 1831189596 | Robert M Whitehouse | Internal Medicine | 417 State St, Bangor, ME 04401-6630 | 2005-10-25 |
| 1538165402 | Stephen Gerard Comeau | Internal Medicine | 417 State St, Ste 321, Bangor, ME 04401-6638 | 2005-06-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184133746 | Abd Assalam Qannus | Internal Medicine | 22 Bramhall St Rm 5219, Portland, ME 04102-3134 | 2017-09-27 |
| 1023403748 | Sarah Gilligan | Internal Medicine | 19 Capisic St, Portland, ME 04102-2203 | 2015-03-31 |
| 1174825707 | Catherine Stehman-breen | Internal Medicine | 5 Meetinghouse Ln, York, ME 03909-1073 | 2010-12-02 |
| 1578635132 | Myra Altman | Internal Medicine | 16 Fahey Street, Suite 107, Belfast, ME 04915 | 2006-11-15 |
| 1598721631 | Mainegeneral Health Associates | Internal Medicine | Nephrology Services, 149 North St., Waterville, ME 04901 | 2006-04-26 |
| 1053301747 | Shahid Mansoor | Internal Medicine | 19 Vanasse Rd, Eastport, ME 04631-3860 | 2005-10-25 |
| 1780684407 | Barbara Oberg-higgins | Internal Medicine | 6 Glen Cove Drive, Rockport, Rockport, ME 04856-7533 | 2005-07-22 |
| 1649278029 | Paul A Parker | Internal Medicine | 1600b Congress St, Portland, ME 04102-2124 | 2005-07-11 |
| 1386640258 | Suzanne Humphries | Internal Medicine | 435 Muzzy Ridge Rd, Searsmont, ME 04973-3202 | 2005-06-24 |
| 1396290763 | Amjad Mehboob | Internal Medicine | 22 Bramhall St, Maine Medical Center, Portland, ME 04102-3134 | 2016-08-16 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on NORTHEAST NEPHROLOGY PA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.