Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 014624 | ME |
NPI | 1053406827 |
---|---|
Provider Name | Ms. Alice C Androkites |
First Address | Rockport, ME 04856 |
Second Address | Rockport, ME 04856 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B42275 | (02) |