- Practice location
- 331 Veranda St, Portland, ME 04103-5545
- Phone
- 207-828-2402
- Fax
- —
- Last updated
- October 2, 2020
Mary Iaculli is a Family Medicine, Sports Medicine based in Portland, ME. Mary Iaculli practices in Portland, ME and has the professional credentials of DO. The NPI Number for Mary Iaculli is 1407266778 and holds a License No. DO2695 (ME). The current practice location address for Mary Iaculli is 331 Veranda St, Portland, ME 04103-5545 and can be reached out via phone at 207-828-2402.
Provider Profile Details
- NPI Number
- 1407266778
- Provider Name
- Mary Iaculli
- Credential
- DO
- Provider Entity Type
- Individual
- Gender
- Female
- Address
- 331 Veranda St, Portland, ME 04103-5545
- Phone Number
- 207-828-2402
- Primary Taxonomy
- Family Medicine, Sports Medicine · 207QS0010X
- Sole Proprietor
- Yes
- Provider Enumeration Date
- May 7, 2014
- Last Update Date
- October 2, 2020
- Certification Date
- September 17, 2020
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 331 Veranda St
Portland, ME 04103-5545 - City
- Portland
- State
- Maine
- Zip
- 04103-5545
- Phone Number
- 207-828-2402
Provider Business Mailing Address Details
- Address
- Po Box 9746
Portland, ME 04104-5040 - City
- Portland
- State
- ME
- Zip
- 04104-5040
License Information
- License Number
- DO2695
- License State
- ME
- Taxonomy
- Family Medicine, Sports Medicine · 207QS0010X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
Other Family Medicine, Sports Medicine providers near Portland, ME
View all Family Medicine, Sports Medicine providers in Portland →- Dr. William W Dexter, MDFamily Medicine, Sports Medicine · NPI 1396739520
- Heidi Walls, MDFamily Medicine, Sports Medicine · NPI 1902291446
- Justin D Wendler, PMHNPNurse Practitioner, Psych/Mental Health · NPI 1518885672
- MainehealthGeneral Acute Care Hospital · NPI 1467352344
- MainehealthGeneral Acute Care Hospital · NPI 1356241327
- MainehealthGeneral Acute Care Hospital · NPI 1790685774
Frequently Asked Questions
What is the NPI number of Dr. Mary Iaculli, DO?
The NPI number of Dr. Mary Iaculli, DO is 1407266778. It was assigned on May 7, 2014 and is currently active in the NPPES registry.
What is the specialty of Dr. Mary Iaculli, DO?
Dr. Mary Iaculli, DO is registered under the primary taxonomy Family Medicine, Sports Medicine (code 207QS0010X), licensed in ME under license number DO2695.
Where does Dr. Mary Iaculli, DO practice?
The practice location is 331 Veranda St, Portland, ME 04103-5545. The office can be reached at 207-828-2402 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1407266778 directly on the NPPES registry website.