Provider Demographics
NPI:1265755797
Name:FURMAN, ROGER J (ROGER FURMAN)
Entity type:Individual
Prefix:
First Name:ROGER
Middle Name:J
Last Name:FURMAN
Suffix:
Gender:M
Credentials:ROGER FURMAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:153 SHAKER HILL RD APT 3
Mailing Address - Street 2:APT #3
Mailing Address - City:ENFIELD
Mailing Address - State:NH
Mailing Address - Zip Code:03748-3042
Mailing Address - Country:US
Mailing Address - Phone:603-632-4876
Mailing Address - Fax:
Practice Address - Street 1:VETERANS AFFAIRS MEDICAL CTR
Practice Address - Street 2:
Practice Address - City:WHITE RIVER JUNCTION
Practice Address - State:VT
Practice Address - Zip Code:05009-0001
Practice Address - Country:US
Practice Address - Phone:802-295-9363
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-11
Last Update Date:2010-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH015123-22164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse