Provider Demographics
NPI:1851597439
Name:COMPAGNONE, GINO (PT)
Entity Type:Individual
Prefix:MR
First Name:GINO
Middle Name:
Last Name:COMPAGNONE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:210 COMMERCE WAY
Mailing Address - Street 2:SUITE 120
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-8200
Mailing Address - Country:US
Mailing Address - Phone:207-439-2675
Mailing Address - Fax:207-439-4965
Practice Address - Street 1:64 PORTSMOUTH AVE
Practice Address - Street 2:SUITE 5
Practice Address - City:STRATHAM
Practice Address - State:NH
Practice Address - Zip Code:03885-2523
Practice Address - Country:US
Practice Address - Phone:603-772-8222
Practice Address - Fax:603-772-6738
Is Sole Proprietor?:No
Enumeration Date:2007-06-21
Last Update Date:2013-02-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NH3208225100000X
MA17333225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHRE8243Medicare PIN