Provider Demographics
NPI:1548228463
Name:PISCOPO, MARK (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:
Last Name:PISCOPO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:185 QUEEN CITY AVE
Mailing Address - Street 2:ELLIOT ORTHOPAEDIC SURGERY SPECIALISTS
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03101-7100
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:185 QUEEN CITY AVE
Practice Address - Street 2:ELLIOT ORTHOPAEDIC SURGERY SPECIALISTS
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03101-7100
Practice Address - Country:US
Practice Address - Phone:603-625-1655
Practice Address - Fax:603-626-4686
Is Sole Proprietor?:No
Enumeration Date:2006-05-02
Last Update Date:2011-04-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NH8097207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHNAS928OtherHARVARD PILGRIM
NH708165OtherTUFTS
NH0103992Y0NH01OtherANTHEM BC/BS
NH101105300OtherDEPARTMENT OF LABOR
NHRE6661OtherMEDICARE GROUP NUMBER
NH020504866003OtherCIGNA
NH020504866003OtherCIGNA
NHNAS928OtherHARVARD PILGRIM