Provider Demographics
NPI:1275520009
Name:DAMASCO, REMELINE C (MD)
Entity Type:Individual
Prefix:
First Name:REMELINE
Middle Name:C
Last Name:DAMASCO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:69 ISLAND ST STE C
Mailing Address - Street 2:
Mailing Address - City:KEENE
Mailing Address - State:NH
Mailing Address - Zip Code:03431-3507
Mailing Address - Country:US
Mailing Address - Phone:603-354-5454
Mailing Address - Fax:603-354-6704
Practice Address - Street 1:590 COURT ST
Practice Address - Street 2:DARTMOUTH HITCHCOCK - INTERNAL MED
Practice Address - City:KEENE
Practice Address - State:NH
Practice Address - Zip Code:03431
Practice Address - Country:US
Practice Address - Phone:603-354-5400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-06
Last Update Date:2018-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT042-0010649207R00000X
NH15404207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1010347Medicaid
VT1010347Medicaid
NH30204135Medicaid
NHVN334002Medicare PIN
MX8039Medicare PIN