National Provider Identifier Database

PEDIATRIC CARDIOLOGY ASSOC PA
Pediatric Cardiology

A pediatric cardiologist provides comprehensive care to patients with cardiovascular problems. This specialist is skilled in selecting, performing and evaluating the structural and functional assessment of the heart and blood vessels, and the clinical evaluation of cardiovascular disease.


Contact Information

PEDIATRIC CARDIOLOGY ASSOC PA
71 US ROUTE 1
SUITE C
SCARBOROUGH, ME04074-7173
Phone: 207-883-5532
Fax: 207-883-5552
Website:
Specialty Taxonomy Code
* Pediatric Cardiology 2080P0202X

* Indicates primary specialty

NPI Profile & details for PEDIATRIC CARDIOLOGY ASSOC PA

NPI Number 1346311925
Legal business name
LBN
PEDIATRIC CARDIOLOGY ASSOC PA
Authorized official JON DONNELLY - (PRESIDENT)
Entity Organization
Organization subpart No
Enumeration date 11/13/2006
Last updated 08/28/2017 - About 9 years ago
Sole proprietor1 Not specified
Identifiers
  • ME License #: 014324
  • ME Medicaid: 112590000
  • NH Medicaid: 30004962

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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