Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 3188 | NH |
NPI | 1114970241 |
---|---|
Provider Name | Richard J. Rosato |
First Address | Concord, NH 03301-5321 |
Second Address | Concord, NH 03301-5321 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02Y002478NH02 | BLUECROSS BLUESHIELD (01) | NH |
1053 | NORTHEAST DELTA DENTAL (01) | NH |
1393 | CIGNA (01) | NH |
30314308 | (05) | NH |
U70247 | (02) | NH |