Provider Demographics
NPI:1518363415
Name:LURGIO, ADAM J (PA)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:J
Last Name:LURGIO
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 BUTTRICK RD 102
Mailing Address - Street 2:
Mailing Address - City:LONDONDERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03053-3417
Mailing Address - Country:US
Mailing Address - Phone:603-537-1300
Mailing Address - Fax:603-537-1326
Practice Address - Street 1:6 OLD FREMONT ROAD EXT
Practice Address - Street 2:
Practice Address - City:RAYMOND
Practice Address - State:NH
Practice Address - Zip Code:03077-2380
Practice Address - Country:US
Practice Address - Phone:603-537-1300
Practice Address - Fax:603-244-7018
Is Sole Proprietor?:No
Enumeration Date:2014-11-05
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0781884-1363A00000X
NH1119363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant