Provider Demographics
NPI:1720023914
Name:VALLEY RADIOLOGISTS, P.A.
Entity Type:Organization
Organization Name:VALLEY RADIOLOGISTS, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:HASEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-674-6711
Mailing Address - Street 1:243 ELM ST
Mailing Address - Street 2:
Mailing Address - City:CLAREMONT
Mailing Address - State:NH
Mailing Address - Zip Code:03743-4921
Mailing Address - Country:US
Mailing Address - Phone:603-826-2911
Mailing Address - Fax:
Practice Address - Street 1:243 ELM ST
Practice Address - Street 2:
Practice Address - City:CLAREMONT
Practice Address - State:NH
Practice Address - Zip Code:03743-4921
Practice Address - Country:US
Practice Address - Phone:603-826-2911
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-19
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT0003648Medicaid
303648OtherMATHEW THORTON
VTVALL00003648OtherBCBS VT
NH81303648Medicaid
NH303648OtherBCBS NH
CB4628OtherRAILROAD MEDICARE
VT0003648Medicaid
VTVALL00003648OtherBCBS VT