Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 1321 | ME |
NPI | 1104801968 |
---|---|
Provider Name | Jane E Carreiro |
First Address | Biddeford, ME 04005-0626 |
Second Address | Saco, ME 04072-1543 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/12/2005 |
Last Update Date | 28/09/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
018065 | BCBS (01) | ME |
1104801968 | (05) | ME |
120002424 | RR MEDICARE (01) | ME |
2362375 | AETNA (01) | ME |
620091501 | CIGNA (01) | ME |
E70839 | (02) | ME |