1841204583 NPI number — MARYANNE CORMIER DC

Table of content: MARYANNE CORMIER DC (NPI 1841204583)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841204583 NPI number — MARYANNE CORMIER DC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CORMIER
Provider First Name:
MARYANNE
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1841204583
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
58 RANGE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WINDHAM
Provider Business Mailing Address State Name:
NH
Provider Business Mailing Address Postal Code:
03087-2026
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
603-893-6310
Provider Business Mailing Address Fax Number:
603-892-2841

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
58 RANGE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WINDHAM
Provider Business Practice Location Address State Name:
NH
Provider Business Practice Location Address Postal Code:
03087-2026
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
603-893-6310
Provider Business Practice Location Address Fax Number:
603-893-2841
Provider Enumeration Date:
07/28/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  236-0686C , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 04-65350 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 020417401 . This is a "NGS AMERICAN" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 1163089 . This is a "FIRST HEALTH" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: Y39724 . This is a "BCBS MA" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 020417401 . This is a "BENEFIT ADMINISTRATORS" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 0504627Y0NH01 . This is a "ANTHEM" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 544350 . This is a "AETNA" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: NA1572 . This is a "HARVARD PILGRIM" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: GA44-04092 . This is a "UNITED HEALTHCARE- GA" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 020417401 . This is a "HEALTHCARE MANAGEMENT" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 5411 . This is a "CIGNA" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 020417401 . This is a "GREAT WEST" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 020417401 . This is a "MAIL HANDLERS" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 020417401 . This is a "UNICARE" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 761532 . This is a "TUFTS HEALTH PLAN" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: RE2188 . This is a "BCBS MA" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com