Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 2808 | NH |
NPI | 1083611719 |
---|---|
Provider Name | Tammy E Ciminesi |
First Address | Bow, NH 03304-5313 |
Second Address | Concord, NH 03301-5641 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2005 |
Last Update Date | 08/03/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
08Y004536NH01 | ANTHEM (01) | NH |
30392270 | (05) | NH |