Provider Demographics
NPI:1447235395
Name:CARDIOTHORACIC SURGICAL ASSOCIATES, P.A.
Entity Type:Organization
Organization Name:CARDIOTHORACIC SURGICAL ASSOCIATES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:YVON
Authorized Official - Middle Name:
Authorized Official - Last Name:BARIBEAU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:603-663-6340
Mailing Address - Street 1:100 MCGREGOR ST
Mailing Address - Street 2:SUITE B600A
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03102-3730
Mailing Address - Country:US
Mailing Address - Phone:603-663-6340
Mailing Address - Fax:
Practice Address - Street 1:100 MCGREGOR ST
Practice Address - Street 2:SUITE B600A
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03102-3730
Practice Address - Country:US
Practice Address - Phone:603-663-6340
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-14
Last Update Date:2013-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH80008700Medicaid
NH80008700Medicaid