Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 0299 | NH |
NPI | 1033216122 |
---|---|
Provider Name | Dr. Peter Kasyjanski |
First Address | Manchester, NH 03104 |
Second Address | Manchester, NH 03104 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 19/05/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
029900 | TUFTS (01) | |
03YO03817NH03 | ANTHEM BCBS NH (01) | NH |
333797 | HARVARD PILGRIM (01) | |
U90353 | (02) |