Mary Ellen Gellerstedt, M.D.

Primary specialty

Developmental - Behavioral Pediatrics PhysicianTaxonomy code 2080P0006X

License

016840 Issued in ME

Practice address

133 Corporate Dr
Emmc
Bangor, ME 04401-4312

Phone

(207) 973-7520

Fax

(207) 973-7674

NPI assigned

Jul 4, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487894400000",
    "number": "1457381568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 WHITING HILL RD STE 300",
            "address_2": "EMMC",
            "city": "BREWER",
            "state": "ME",
            "postal_code": "044121006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 CORPORATE DR",
            "address_2": "EMMC",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044014312",
            "telephone_number": "207-973-7520",
            "fax_number": "207-973-7674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GELLERSTEDT",
        "first_name": "MARY",
        "middle_name": "ELLEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-04",
        "last_updated": "2017-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0006X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "ME",
            "license": "016840",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Humayun Gazder, M.D.
• Lyudmila A Gazder, NP
• Kelly Jean Gebler, CRNA
• Airelle Michelle Gelinas
• Jordyn N Gelineau, OT
• Catherine Ann Gels-Birch, RN
• Lawrence Charles Gendreau, LADC
• Emily Eulalia Genever, LCPC-C, MHRT-CSP
• Genoa Healthcare LLC
• Joshua Levi George, MD

• Developmental - Behavioral Pediatrics Physician in Bangor, ME
• Providers in Bangor, ME by specialty
• Developmental - Behavioral Pediatrics Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2017; 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.