Basic Information
| Provider Information | |||||||||
| NPI: | 1588739874 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ARMELLINO | ||||||||
| FirstName: | NICHOLAS | ||||||||
| MiddleName: | C | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 15 HOSPITAL DR | ||||||||
| Address2: | |||||||||
| City: | YORK | ||||||||
| State: | ME | ||||||||
| PostalCode: | 039091011 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2072634321 | ||||||||
| FaxNumber: | 2073630120 | ||||||||
| Practice Location | |||||||||
| Address1: | 15 HOSPITAL DR | ||||||||
| Address2: | |||||||||
| City: | YORK | ||||||||
| State: | ME | ||||||||
| PostalCode: | 039091011 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2072634321 | ||||||||
| FaxNumber: | 2073630120 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/21/2006 | ||||||||
| LastUpdateDate: | 06/11/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 14186 | NH | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207P00000X | T0612 | ME | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
ID Information
| ID | Type | State | Issuer | Description | 0642976 | 01 | NH | CIGNA | OTHER | 2130424 | 05 | MA | MEDICAID | 1588739874 | 01 | NH | ANTHEM BCBS NH | OTHER | AA136485 | 01 | NH | HARVARD PILGRIM HEALTHCARE NE | OTHER | P00767952 | 01 | NH | RAILROAD MEDICARE | OTHER | 30227124 | 05 | NH | MEDICAID | 433481399 | 05 | ME | MEDICAID |