Provider Demographics
NPI:1427020395
Name:SEACOAST RADIOLOGY, PA
Entity Type:Organization
Organization Name:SEACOAST RADIOLOGY, PA
Other - Org Name:DOVER-ROCHESTER ASSOCIATES IN RADIOLOGY, PA
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:W
Authorized Official - Last Name:CIASCHINI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:603-516-1307
Mailing Address - Street 1:PO BOX 9567
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03108-9567
Mailing Address - Country:US
Mailing Address - Phone:603-516-1307
Mailing Address - Fax:603-516-1308
Practice Address - Street 1:789 CENTRAL AVENUE
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:NH
Practice Address - Zip Code:03820-6420
Practice Address - Country:US
Practice Address - Phone:603-516-1307
Practice Address - Fax:603-516-4221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-06
Last Update Date:2021-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH82304030Medicaid
NH164OtherCIGNA HEALTHCARE HMO
NHDOVE304030OtherANTHEM BC & BS NH
NH82304030Medicaid