Bruce Lackie

Address: 56 Taylor Rd, Orono, ME 04473-3205
Phone: 2079443982

Bruce Lackie (NPI# 1629189824, PAC ID# 4688621477) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is CLINICAL SOCIAL WORKER.

Physician Overview

Nation Provider ID (NPI) 1629189824
PAC ID by PECOS 4688621477
Professional Enrollment ID I20070323000315
Full Name Bruce Lackie
Address 56 Taylor Rd
Orono
ME 04473-3205
Phone Number 2079443982
Gender M
Credential CSW
Graduation Year 1971
Primary Specialty CLINICAL SOCIAL WORKER
Accepts Medicare Assignment Y

Other Locations

Address Phone Organization
56 Taylor Rd, Orono, ME 04473-3205 2079443982

Organization Information

Office Location

Street Address 56 TAYLOR RD
City ORONO
State ME
Zip 04473-3205

Competitor

Search similar physicians

City ORONO
Zip Code 04473
Specialty CLINICAL SOCIAL WORKER
City + Specialty ORONO + CLINICAL SOCIAL WORKER

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS)
Jurisdiction Medicare

This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.