Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207N00000X | Dermatologist | 015155 | ME |
Y | 207N00000X | Dermatologist | 10730 | NH |
NPI | 1033214077 |
---|---|
Provider Name | Dr. Joan S Sisto |
First Address | North Andover, MA 01845-5076 |
Second Address | Portsmouth, NH 03801-7156 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/09/2006 |
Last Update Date | 16/05/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01Y002300NH01 | ANTHEM NEW HAMPSHIRE (01) | NH |
039185 | ANTHEM MAINE (01) | ME |
2454120 | AETNA (01) | |
H09161 | (02) | |
H09161 | HARVARD (01) | |
P00321023 | RAILROAD MEDICARE (01) | NH |