| Sally A Cooper, MD | |
|
123 Andover Rd, Westbrook, ME 04092-3848 | |
| (207) 761-2200 | |
| (207) 761-2108 |
| Full Name | Sally A Cooper |
|---|---|
| Gender | Female |
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 123 Andover Rd, Westbrook, Maine |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013070580 | NPI | - | NPPES |
| 1013070580 | Medicaid | ME | |
| 104540000 | Medicaid | ME |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | MD14099 (Maine) | Primary |
| Entity Name | St Marys Regional Medical Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1447226584 PECOS PAC ID: 0042107120 Enrollment ID: O20040303000236 |
| Entity Name | Community Clinical Services Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1164477568 PECOS PAC ID: 0042101099 Enrollment ID: O20040513000884 |
| Entity Name | Mainehealth |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1790265502 PECOS PAC ID: 7517860588 Enrollment ID: O20040701000166 |
| Mailing Address | Practice Location Address |
|---|---|
| Sally A Cooper, MD 78 Atlantic Pl, South Portland, ME 04106-2316 Ph: (207) 661-6654 | Sally A Cooper, MD 123 Andover Rd, Westbrook, ME 04092-3848 Ph: (207) 761-2200 |
David F Ray, MD Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 123 Andover Rd, Westbrook, ME 04092 Phone: 207-761-2200 Fax: 207-761-7773 | |
Dr. Shannon Janice Ezovski, MD Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 123 Andover Rd, Westbrook, ME 04092 Phone: 207-761-2200 | |
Dr. Sarah Gumlak, MD Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 123 Andover Rd, Westbrook, ME 04092 Phone: 207-761-2200 | |
Girard E Robinson, MD Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 123 Andover Rd, Westbrook, ME 04092 Phone: 207-761-2200 Fax: 207-842-7773 | |
Dr. Gabriel E. Matos, MD Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 123 Andover Rd, Westbrook, ME 04092 Phone: 207-761-2200 | |
Dr. Melissa M Bowker-kinley, MD Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 123 Andover Rd, Westbrook, ME 04092 Phone: 207-761-2200 Fax: 207-761-2108 |