Provider Demographics
NPI:1861522476
Name:DOWN EAST ORTHOPEDIC ASSOCIATES
Entity type:Organization
Organization Name:DOWN EAST ORTHOPEDIC ASSOCIATES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:HUGHES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-947-8381
Mailing Address - Street 1:404 STATE ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-6623
Mailing Address - Country:US
Mailing Address - Phone:207-942-7630
Mailing Address - Fax:207-942-5686
Practice Address - Street 1:404 STATE ST
Practice Address - Street 2:SUITE 400
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-6623
Practice Address - Country:US
Practice Address - Phone:207-942-7630
Practice Address - Fax:207-942-5686
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPT2184225100000X
MEOT1533225X00000X
MEPT3023225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME3202508OtherCIGNA GROUP ID
MEMN2318OtherHARVARD PILGRIM GROUP ID
ME3202508OtherCIGNA GROUP ID