Provider Demographics
NPI:1205816071
Name:NEW HAMPSHIRE ORTHOPAEDIC SURGERY, PA
Entity Type:Organization
Organization Name:NEW HAMPSHIRE ORTHOPAEDIC SURGERY, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:W
Authorized Official - Last Name:SOGHIKIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:603-669-5454
Mailing Address - Street 1:700 LAKE AVE
Mailing Address - Street 2:SUITE ONE
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03103-2734
Mailing Address - Country:US
Mailing Address - Phone:603-669-5454
Mailing Address - Fax:603-641-0360
Practice Address - Street 1:700 LAKE AVE
Practice Address - Street 2:SUITE ONE
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03103-2734
Practice Address - Country:US
Practice Address - Phone:603-669-5454
Practice Address - Fax:603-641-0360
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-18
Last Update Date:2007-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH99003602Medicaid
NH99003602Medicaid
NH0389700001Medicare NSC