| Mary Desalle, GNP | |
|
655 Main St, Saco, ME 04072-1543 | |
| (207) 602-3571 | |
| (207) 602-3573 |
| Full Name | Mary Desalle |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner - Gerontology |
| Location | 655 Main St, Saco, Maine |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427034396 | NPI | - | NPPES |
| 100072 | Other | ME | BCBS |
| 304310001 | Other | ME | CIGNA |
| 1427034396 | Medicaid | ME | |
| 2735452 | Other | ME | AETNA |
| MN5036 | Other | ME | HPHC |
| 500017332 | Other | ME | RR MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LG0600X | Nurse Practitioner - Gerontology | R026628 (Maine) | Secondary |
| 363LG0600X | Nurse Practitioner - Gerontology | AP081312 (Maine) | Primary |
| Entity Name | Androscoggin Home Health Services Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1013957687 PECOS PAC ID: 2668467614 Enrollment ID: O20040419000628 |
| Mailing Address | Practice Location Address |
|---|---|
| Mary Desalle, GNP Po Box 284, Brattleboro, VT 05302-0284 Ph: (207) 784-2554 | Mary Desalle, GNP 655 Main St, Saco, ME 04072-1543 Ph: (207) 602-3571 |
Courtney Matthews, FNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 655 Main St, Saco, ME 04072 Phone: 207-294-5600 | |
Elise Scala, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 655 Main Street, Saco, ME 04072 Phone: 207-602-3571 Fax: 207-602-3573 | |
Ms. Allison Talon, ANP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 15 Lund Rd, Saco, ME 04072 Phone: 207-282-4210 | |
Mrs. Mary M Hannaford, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 655 Main St, Saco, ME 04072 Phone: 207-294-3100 Fax: 207-286-3709 | |
Mrs. Linda P. Sillars, PMHNP, BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 35 Stockman Ave, Saco, ME 04072 Phone: 315-253-0341 Fax: 315-253-1687 | |
Alexis M Mccrossin, FNPC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 13 Industrial Park Rd, Saco, ME 04072 Phone: 207-283-8800 Fax: 207-294-3561 | |
Judith A Metcalf, ANP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 655 Main St, Saco, ME 04072 Phone: 207-602-3571 Fax: 207-602-3573 |