Provider Demographics
NPI:1427011568
Name:GUILFOYLE, PETER ANTHONY (PA-C)
Entity type:Individual
Prefix:MR
First Name:PETER
Middle Name:ANTHONY
Last Name:GUILFOYLE
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:655 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SACO
Mailing Address - State:ME
Mailing Address - Zip Code:04072-1699
Mailing Address - Country:US
Mailing Address - Phone:207-294-5600
Mailing Address - Fax:
Practice Address - Street 1:19 S GORHAM XING
Practice Address - Street 2:
Practice Address - City:GORHAM
Practice Address - State:ME
Practice Address - Zip Code:04038-2690
Practice Address - Country:US
Practice Address - Phone:207-535-1400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT104-00001052255A2300X
VT055.0031165363A00000X
MEPA1400363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer