Provider Demographics
NPI:1639358450
Name:BRUCE BARTOLINI MD PA
Entity Type:Organization
Organization Name:BRUCE BARTOLINI MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:
Authorized Official - Last Name:BARTOLINI
Authorized Official - Suffix:
Authorized Official - Credentials:MD PA
Authorized Official - Phone:603-772-4768
Mailing Address - Street 1:PO BOX 271
Mailing Address - Street 2:
Mailing Address - City:STRATHAM
Mailing Address - State:NH
Mailing Address - Zip Code:03885-0271
Mailing Address - Country:US
Mailing Address - Phone:603-772-4768
Mailing Address - Fax:
Practice Address - Street 1:257 PORTSMOUTH AVE
Practice Address - Street 2:
Practice Address - City:STRATHAM
Practice Address - State:NH
Practice Address - Zip Code:03885-2230
Practice Address - Country:US
Practice Address - Phone:603-772-4768
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-29
Last Update Date:2007-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH5704207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHNH4188Medicare PIN