Provider Demographics
NPI:1588699177
Name:PINTER, CECILIA JUDITH (PA-C)
Entity type:Individual
Prefix:
First Name:CECILIA
Middle Name:JUDITH
Last Name:PINTER
Suffix:
Gender:F
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 1:10 CARTER ST.
Mailing Address - Street 2:PO BOX 309
Mailing Address - City:EAGLE LAKE
Mailing Address - State:ME
Mailing Address - Zip Code:04739-0309
Mailing Address - Country:US
Mailing Address - Phone:207-444-5973
Mailing Address - Fax:207-444-5520
Practice Address - Street 1:10 CARTER ST.
Practice Address - Street 2:
Practice Address - City:EAGLE LAKE
Practice Address - State:ME
Practice Address - Zip Code:04739-0309
Practice Address - Country:US
Practice Address - Phone:207-444-5973
Practice Address - Fax:207-444-5520
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2008-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPA358363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME282810099Medicaid
ME201802Medicare Oscar/Certification
MEMM2976Medicare PIN
ME282810099Medicaid