Basic Information
| Provider Information | |||||||||
| NPI: | 1003369323 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HAMBARDZUMYAN | ||||||||
| FirstName: | VACHE | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 458 OLD STREET RD STE 200 | ||||||||
| Address2: | |||||||||
| City: | PETERBOROUGH | ||||||||
| State: | NH | ||||||||
| PostalCode: | 034581216 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6039242144 | ||||||||
| FaxNumber: | 6039243993 | ||||||||
| Practice Location | |||||||||
| Address1: | 458 OLD STREET RD STE 200 | ||||||||
| Address2: | |||||||||
| City: | PETERBOROUGH | ||||||||
| State: | NH | ||||||||
| PostalCode: | 034581216 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6039242144 | ||||||||
| FaxNumber: | 6039243993 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/03/2016 | ||||||||
| LastUpdateDate: | 08/03/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 08/03/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | P32690 | MD | N | Hospitals | General Acute Care Hospital | 207XX0801X | 22367 | NH | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Orthopaedic Trauma |
No ID Information.