1730276908 NPI number — MR. STEVE DOCZY-BORDI PA

Table of content: MR. STEVE DOCZY-BORDI PA (NPI 1730276908)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730276908 NPI number — MR. STEVE DOCZY-BORDI PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DOCZY-BORDI
Provider First Name:
STEVE
Provider Middle Name:
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
PA
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:
1730276908
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/09/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2 HAROLD HOWELL WAY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WINTHROP
Provider Business Mailing Address State Name:
ME
Provider Business Mailing Address Postal Code:
04364-3733
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
207-512-2220
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
150 MAIN ROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ISLESBORO
Provider Business Practice Location Address State Name:
ME
Provider Business Practice Location Address Postal Code:
04848-0137
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
207-734-2213
Provider Business Practice Location Address Fax Number:
207-734-8392
Provider Enumeration Date:
10/06/2006

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: 363AM0700X , with the licence number:  PA-481 , 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)





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