Provider Demographics
NPI:1962602193
Name:PORENSKY, PAUL NICHOLAS (MD)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:NICHOLAS
Last Name:PORENSKY
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:92 CAMPUS DR STE A
Mailing Address - Street 2:
Mailing Address - City:SCARBOROUGH
Mailing Address - State:ME
Mailing Address - Zip Code:04074-7229
Mailing Address - Country:US
Mailing Address - Phone:207-885-0011
Mailing Address - Fax:207-885-5851
Practice Address - Street 1:92 CAMPUS DR STE A
Practice Address - Street 2:
Practice Address - City:SCARBOROUGH
Practice Address - State:ME
Practice Address - Zip Code:04074-7229
Practice Address - Country:US
Practice Address - Phone:207-885-0011
Practice Address - Fax:207-885-5851
Is Sole Proprietor?:No
Enumeration Date:2007-07-25
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.123589207T00000X
MEMD28964207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery