| Beata A Wiktor, Inc | |
|
6 Main St Suite 1 Gray ME 04039-9502 | |
| (207) 657-8311 | |
| Not Available |
| Full Name | Beata A Wiktor, Inc |
|---|---|
| Speciality | Psychologist |
| Location | 6 Main St, Gray, Maine |
| Authorized Official Name and Position | Beata A Wiktor (PRESIDENT) |
| Authorized Official Contact | 2072005925 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Beata A Wiktor, Inc Po Box 1614 Windham ME 04062-1614 Ph: (207) 200-5925 | Beata A Wiktor, Inc 6 Main St Suite 1 Gray ME 04039-9502 Ph: (207) 657-8311 |
| NPI Number | 1689064511 |
|---|---|
| Provider Enumeration Date | 01/30/2015 |
| Last Update Date | 01/30/2015 |
| Medicare PECOS PAC ID | 6709103906 |
|---|---|
| Medicare Enrollment ID | O20150327001399 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689064511 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | PS1417 (Maine) | Primary |
| Provider Name | Beata A Wiktor |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1528398104 PECOS PAC ID: 0345462321 Enrollment ID: I20141106000726 |
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