Pine Tree Eye Associates, PA

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT942 Issued in ME

Legal business name

PINE TREE EYE ASSOCIATES, PA

Practice address

166 Silver St
Waterville, ME 04901-5815

Phone

(207) 873-3500

Fax

(207) 873-6167

NPI assigned

Mar 23, 2018

Organization subpart

No

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

Authorized official

Name

Arielle L Costello, OD

Title

Owner/Optometrist

Phone

(207) 873-3500

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1521763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521763200000",
    "number": "1447754312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "166 SILVER ST",
            "city": "WATERVILLE",
            "state": "ME",
            "postal_code": "049015815",
            "telephone_number": "207-873-3500",
            "fax_number": "207-873-6167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "166 SILVER ST",
            "city": "WATERVILLE",
            "state": "ME",
            "postal_code": "049015815",
            "telephone_number": "207-873-3500",
            "fax_number": "207-873-6167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINE TREE EYE ASSOCIATES, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-23",
        "last_updated": "2018-03-23",
        "status": "A",
        "authorized_official_last_name": "COSTELLO",
        "authorized_official_first_name": "ARIELLE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER/OPTOMETRIST",
        "authorized_official_telephone_number": "207-873-3500",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "ME",
            "license": "OPT942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Theresa Msrie Phillips, RN
• Jean Piccini, CADC
• Timothy T Pieh, MD
• Gitali Piekarska Guanel, DO
• Daniel Pierce II
• Pine Valley Home Care LLC
• Gabriel Pinnette, LCSW
• Jenny T Pisculli, MD
• Kristyn Elizabeth Plamondon, LCPC-C
• Donnajean Pohlman

• Optometrist in Waterville, ME
• Providers in Waterville, ME by specialty
• Optometrist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2018; 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.