Provider Demographics
NPI:1225258767
Name:SANZONE, SAMUEL V (DC)
Entity Type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:V
Last Name:SANZONE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 MANCHESTER ST
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-5140
Mailing Address - Country:US
Mailing Address - Phone:603-229-0021
Mailing Address - Fax:603-229-0051
Practice Address - Street 1:85 MANCHESTER ST
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-5140
Practice Address - Country:US
Practice Address - Phone:603-229-0021
Practice Address - Fax:603-229-0051
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH155-1093111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
RE2932Medicare PIN
U46523Medicare UPIN