| Tom Negron, Ph.d. | |
|
4 Cummings Dr Gorham ME 04038-2452 | |
| (207) 772-1164 | |
| (207) 772-2670 |
| Full Name | Tom Negron, Ph.d. |
|---|---|
| Speciality | Psychologist |
| Location | 4 Cummings Dr, Gorham, Maine |
| Authorized Official Name and Position | Tom Negron (PRESIDENT) |
| Authorized Official Contact | 2077721164 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tom Negron, Ph.d. Po Box 788 Windham ME 04062-0788 Ph: (207) 772-1164 | Tom Negron, Ph.d. 4 Cummings Dr Gorham ME 04038-2452 Ph: (207) 772-1164 |
| NPI Number | 1194973131 |
|---|---|
| Provider Enumeration Date | 09/03/2008 |
| Last Update Date | 11/07/2021 |
| Certification Date | 11/07/2021 |
| Medicare PECOS PAC ID | 7214003433 |
|---|---|
| Medicare Enrollment ID | O20080911000338 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194973131 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PSY712 (Maine) | Primary |
| Provider Name | Tom Negron |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1922161686 PECOS PAC ID: 0446322846 Enrollment ID: I20080911000332 |
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