New England Telemedicine PA

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

NEW ENGLAND TELEMEDICINE PA

Doing business as

New England Telemedicine

Practice address

98 Route 236
Suite 2
Kittery, ME 03904-5527

Phone

(855) 275-0464

Fax

(207) 703-2780

NPI assigned

Jul 12, 2013

Last updated

Oct 18, 2013By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Trustin Roy Ennacheril, MD

Title

President/Ceo

Phone

(855) 275-0464

Specialties & licenses 1

Addresses

Other names 1

• New England Telemedicine Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1373587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1382054400000",
    "number": "1053752584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "98 ROUTE 236",
            "address_2": "SUITE #2",
            "city": "KITTERY",
            "state": "ME",
            "postal_code": "039045527",
            "telephone_number": "855-275-0464",
            "fax_number": "207-703-2780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "98 ROUTE 236",
            "address_2": "SUITE 2",
            "city": "KITTERY",
            "state": "ME",
            "postal_code": "039045527",
            "telephone_number": "855-275-0464",
            "fax_number": "207-703-2780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW ENGLAND TELEMEDICINE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-12",
        "last_updated": "2013-10-18",
        "status": "A",
        "authorized_official_last_name": "ENNACHERIL",
        "authorized_official_first_name": "TRUSTIN",
        "authorized_official_middle_name": "ROY",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "855-275-0464",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New England Telemedicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Thurston Olaf Monson II, M.D.
• Erica Mullally
• Thea Emogene Murphy, MSN, FNP-C
• Heidi A Nadeau, LMT
• Naval Health Clinic New England (Dod Portsmouth Kittery Pharmacy)
• New England Telemedicine PA (Paramount Medical Supply)
• Lawrence James Newman, LCPC, LADC
• Cuong Gia Nguyen, D.D.S.
• Reagan Nichols, OTR/L
• Kimberly M O'Connor, RPH

• Multi-Specialty Clinic/Center in Kittery, ME
• Providers in Kittery, ME by specialty
• Multi-Specialty Clinic/Center in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.