Provider Demographics
NPI:1255303582
Name:IORFINO, ANTHONY (MD)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:
Last Name:IORFINO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5001
Mailing Address - Street 2:
Mailing Address - City:NORTH CONWAY
Mailing Address - State:NH
Mailing Address - Zip Code:03860
Mailing Address - Country:US
Mailing Address - Phone:603-356-6045
Mailing Address - Fax:603-356-6553
Practice Address - Street 1:3073 WHITE MOUNTAIN HIGHWAY
Practice Address - Street 2:
Practice Address - City:NORTH CONWAY
Practice Address - State:NH
Practice Address - Zip Code:03860
Practice Address - Country:US
Practice Address - Phone:603-356-6045
Practice Address - Fax:603-356-6553
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2007-07-31
Deactivation Date:2007-07-17
Deactivation Code:
Reactivation Date:2007-07-31
Provider Licenses
StateLicense IDTaxonomies
NH8045174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH0105233Y0NH01OtherANTHEM BLUE CROSS
NH30002798Medicaid
NHB83032Medicare UPIN
NHNT0005Medicare ID - Type UnspecifiedMEDICARE