Provider Demographics
NPI:1568435386
Name:GUARDIANO, ROBERT ANTHONY (DO)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:ANTHONY
Last Name:GUARDIANO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 RAILROAD ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:KEENE
Mailing Address - State:NH
Mailing Address - Zip Code:03431-3987
Mailing Address - Country:US
Mailing Address - Phone:603-354-5454
Mailing Address - Fax:
Practice Address - Street 1:51 RAILROAD ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:KEENE
Practice Address - State:NH
Practice Address - Zip Code:03431-3987
Practice Address - Country:US
Practice Address - Phone:603-354-5454
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-10
Last Update Date:2017-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0102831108207N00000X
NH13860207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30226765Medicaid
NH000959701Medicare PIN