Provider Demographics
NPI:1215107644
Name:SYNERGY HEALTH CARE, PC
Entity type:Organization
Organization Name:SYNERGY HEALTH CARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:M
Authorized Official - Last Name:TRUSLOW
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C, PNP-C
Authorized Official - Phone:207-878-0094
Mailing Address - Street 1:88 NORTH ST
Mailing Address - Street 2:
Mailing Address - City:SACO
Mailing Address - State:ME
Mailing Address - Zip Code:04072-1925
Mailing Address - Country:US
Mailing Address - Phone:207-878-0094
Mailing Address - Fax:
Practice Address - Street 1:88 NORTH ST
Practice Address - Street 2:
Practice Address - City:SACO
Practice Address - State:ME
Practice Address - Zip Code:04072-1925
Practice Address - Country:US
Practice Address - Phone:207-878-0094
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-29
Last Update Date:2012-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MER040324363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME0006078Medicare PIN