Maine Molecular Imaging LLC

Primary specialty

Physiological LaboratoryTaxonomy code 293D00000X

Legal business name

MAINE MOLECULAR IMAGING LLC

Practice address

27 Industrial Ave
Sanford, ME 04073-5820

Phone

(800) 734-4132

Fax

(800) 273-2377

NPI assigned

Sep 8, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Brian G Drazba

Title

Senior VP & Chief Accounting Ofcr

Phone

94928260000

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1157673600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191542400000",
    "number": "1578667994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 414025",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022414025",
            "telephone_number": "949-282-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 INDUSTRIAL AVE",
            "city": "SANFORD",
            "state": "ME",
            "postal_code": "040735820",
            "telephone_number": "800-734-4132",
            "fax_number": "800-273-2377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAINE MOLECULAR IMAGING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-08",
        "last_updated": "2007-10-05",
        "status": "A",
        "authorized_official_last_name": "DRAZBA",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "SENIOR VP & CHIEF ACCOUNTING OFCR",
        "authorized_official_telephone_number": "94928260000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joielle K. Lunny, LCPC-CONDITIONAL
• Natalie Lux
• Donald Lyon, M.D.
• Carl H. Mabee, DDS
• Benjamin Lyle Macdonald, LCPC-C
• Mainehealth (SMHC Sanford Walk In Care)
• Mainehealth
• Mainehealth (SMHC Newton Center)
• Mainehealth (Maine Medical Center)
• Malathy T Sundaram M.D, LLC

• Physiological Laboratory in Sanford, ME
• Providers in Sanford, ME by specialty
• Physiological Laboratory in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2007; 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.