Basic Information
| Provider Information | |||||||||
| NPI: | 1316214646 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MONADNOCK ORTHOPAEDIC ASSOCIATES | ||||||||
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| Mailing Information | |||||||||
| Address1: | 452 OLD STREET RD | ||||||||
| Address2: | |||||||||
| City: | PETERBOROUGH | ||||||||
| State: | NH | ||||||||
| PostalCode: | 034581263 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6039247191 | ||||||||
| FaxNumber: | 6039249586 | ||||||||
| Practice Location | |||||||||
| Address1: | 458 OLD STREET RD | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | PETERBOROUGH | ||||||||
| State: | NH | ||||||||
| PostalCode: | 034581265 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6039242144 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/01/2011 | ||||||||
| LastUpdateDate: | 12/01/2011 | ||||||||
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| AuthorizedOfficialLastName: | SCHEINBLUM | ||||||||
| AuthorizedOfficialFirstName: | RICHARD | ||||||||
| AuthorizedOfficialMiddleName: | D | ||||||||
| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 6039247191 | ||||||||
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| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | MONADNOCK COMMUNITY HOSPITAL | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208100000X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | 208VP0014X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pain Medicine | Interventional Pain Medicine | 207X00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
No ID Information.