1144225475 NPI number — PAUL P COTE O.D.

Table of content: PAUL P COTE O.D. (NPI 1144225475)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144225475 NPI number — PAUL P COTE O.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
COTE
Provider First Name:
PAUL
Provider Middle Name:
P
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
O.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1144225475
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/19/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
249 MAIN ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LEWISTON
Provider Business Mailing Address State Name:
ME
Provider Business Mailing Address Postal Code:
04240-7053
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
207-783-9653
Provider Business Mailing Address Fax Number:
207-786-4362

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
249 MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LEWISTON
Provider Business Practice Location Address State Name:
ME
Provider Business Practice Location Address Postal Code:
04240-7053
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
207-783-9653
Provider Business Practice Location Address Fax Number:
207-786-4362
Provider Enumeration Date:
06/14/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X , with the licence number:  OPT794 , registered in the state of ME ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0005751654 . This is a "AETNA NON-HMO" identifier , issued by the state of ( ME ) . This identifiers is of the category "OTHER".
  • Identifier: 247330099 . This is a "MAINE CARE" identifier , issued by the state of ( ME ) . This identifiers is of the category "OTHER".
  • Identifier: 30009622 . This is a "N.H. MEDICAID/EDS" identifier , issued by the state of ( ME ) . This identifiers is of the category "OTHER".
  • Identifier: U55713 . This is a "HARVARD PILGRIM HEALTH CA" identifier , issued by the state of ( ME ) . This identifiers is of the category "OTHER".
  • Identifier: 1044425 . This is a "AETNA HMO" identifier , issued by the state of ( ME ) . This identifiers is of the category "OTHER".
  • Identifier: 017015 . This is a "ANTHEM BLUE CROSS" identifier , issued by the state of ( ME ) . This identifiers is of the category "OTHER".
  • Identifier: 247330099 , issued by the state of ( ME ) . This identifiers is of the category "MEDICAID".
  • Identifier: 410027558 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( ME ) . This identifiers is of the category "OTHER".




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