Basic Information
| Provider Information | |||||||||
| NPI: | 1104903681 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ORZANO | ||||||||
| FirstName: | A. JOHN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 250 PLEASANT ST | ||||||||
| Address2: | CHFHC - CONCORD | ||||||||
| City: | CONCORD | ||||||||
| State: | NH | ||||||||
| PostalCode: | 033017539 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6032287200 | ||||||||
| FaxNumber: | 6032287307 | ||||||||
| Practice Location | |||||||||
| Address1: | 250 PLEASANT ST | ||||||||
| Address2: | CHFHC - CONCORD | ||||||||
| City: | CONCORD | ||||||||
| State: | NH | ||||||||
| PostalCode: | 033017539 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6032287200 | ||||||||
| FaxNumber: | 6032287307 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/01/2006 | ||||||||
| LastUpdateDate: | 10/15/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 14090 | NH | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | AA124221 | 01 | NH | HARVARD PILGRIM | OTHER | 222594672 | 01 | NH | MARTINS POINT | OTHER | 30208059 | 05 | NH | MEDICAID | 648256 | 01 | NH | CIGNA | OTHER | 222594672 | 01 | NH | PRIVATE HEALTH CARE | OTHER |