Basic Information
| Provider Information | |||||||||
| NPI: | 1952410557 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HARRINGTON | ||||||||
| FirstName: | SHAWN | ||||||||
| MiddleName: | P | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 458 OLD STREET ROAD | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | PETERBOROUGH | ||||||||
| State: | NH | ||||||||
| PostalCode: | 03458 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6039242144 | ||||||||
| FaxNumber: | 6039243993 | ||||||||
| Practice Location | |||||||||
| Address1: | 458 OLD STREET ROAD | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | PETERBOROUGH | ||||||||
| State: | NH | ||||||||
| PostalCode: | 03458 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6039242144 | ||||||||
| FaxNumber: | 6039243993 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/29/2006 | ||||||||
| LastUpdateDate: | 11/09/2015 | ||||||||
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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 | 174400000X | 11247 | NH | N | Other Service Providers | Specialist | 208100000X | 11247 | NH | Y | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation |
ID Information
| ID | Type | State | Issuer | Description | 30201462 | 05 | NH | MEDICAID | 01Y003115NH02 | 01 | NH | ANTHEM BCBS MCH | OTHER | 01Y003115NH03 | 01 | NH | ANTHEM BCBS MOA | OTHER |