PINE TREE WHOLISTIC HEALTH (NPI# 1922467596) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922467596 |
| Entity Type | Organization |
| Organization Name | PINE TREE WHOLISTIC HEALTH |
| Practice Address |
336 Mount Hope Ave Suite 11 Bangor ME 04401-4236 |
| Practice Telephone | 2079422800 |
| Mailing Telephone | 2079422800 |
| Enumeration Date | 2016-02-11 |
| Last Update Date | 2016-02-11 |
| Authorized Official Name | DR. THOMAS J VANIDESTINE JR. (PRESIDENT) |
| Authorized Official Telephone | 2079422800 |
| Authorized Official Credential | DC,CCSP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208VP0014X |
Pain Medicine Specialization: Interventional Pain Medicine |
Allopathic & Osteopathic Physicians |
| Street Address |
336 MOUNT HOPE AVE SUITE 11 |
| City | BANGOR |
| State | ME |
| Zip Code | 04401-4236 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104819598 | Hans Albert Holzwarth | Internal Medicine | 336 Mount Hope Ave, Ste 11, Bangor, ME 04401-4236 | 2005-08-31 |
| 1629147442 | Thomas Hwnry Dwelley | Optometrist | 336 Mount Hope Ave, Suite 6, Bangor, ME 04401-4236 | 2006-11-07 |
| 1184734105 | Mark Ira Lausier | Dentist | 336 Mount Hope Ave, Suite 10, Bangor, ME 04401-4236 | 2006-08-30 |
| 1538108022 | Thomas J Vanidestine Jr. | Chiropractor | 336 Mount Hope Ave, Suite 11, Bangor, ME 04401-4236 | 2006-06-06 |
| 1487600011 | Thomas J Vanidestine Jr | Chiropractor | 336 Mount Hope Ave, Suite 11, Bangor, ME 04401-4236 | 2006-05-25 |
| 1346205457 | Maine Urology Associates P.a. | Urology | 336 Mount Hope Ave, Suite 1, Bangor, ME 04401-4236 | 2006-04-20 |
| 1376534727 | Kathleen H Cousins | Nurse Practitioner | 336 Mount Hope Ave, Bangor, ME 04401-4236 | 2005-11-03 |
| 1104810266 | Lewis Everett Phillips | Internal Medicine | 336 Mount Hope Ave, Ste 11, Bangor, ME 04401-4236 | 2005-09-06 |
| 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 | 208VP0014X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pain Medicine |
| Specialization | Interventional Pain Medicine |
| Interventional Pain Medicine is the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders principally with the application of interventional techniques in managing subacute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatment. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578965521 | Brian E Kaufman, Do, LLC | Pain Medicine | 952 Post Rd, Suite 8, Wells, ME 04090-4149 | 2014-09-22 |
| 1144209123 | Christopher J Delorie | Pain Medicine | 519 Us Route 1, Unit 9, York, ME 03909 | 2006-01-10 |
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| 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.