| NPI | 1386929958 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANJA BUKARAC Physician Assistant 207-749-6383 |
| Organization Subpart ? | No |
| Primary Taxonomy | 284300000X Special Hospital (Licence: NY 015030) |
| Enumeration Date | 2011-10-14 |
| Last Update Date | 2011-10-14 |