Basic Information
| Provider Information | |||||||||
| NPI: | 1659485704 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PERSIN | ||||||||
| FirstName: | MAUREEN | ||||||||
| MiddleName: | C. | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 9353 | ||||||||
| Address2: | |||||||||
| City: | BELFAST | ||||||||
| State: | ME | ||||||||
| PostalCode: | 049159353 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6108660466 | ||||||||
| FaxNumber: | 6108661405 | ||||||||
| Practice Location | |||||||||
| Address1: | 217 W BROAD ST | ||||||||
| Address2: | |||||||||
| City: | BETHLEHEM | ||||||||
| State: | PA | ||||||||
| PostalCode: | 180185517 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6108660466 | ||||||||
| FaxNumber: | 6108661405 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/18/2006 | ||||||||
| LastUpdateDate: | 10/27/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | OS008314L | PA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.