Provider Demographics
NPI:1669573481
Name:GIBSON, CLAUDIA CAVAGNARO (MD)
Entity type:Individual
Prefix:DR
First Name:CLAUDIA
Middle Name:CAVAGNARO
Last Name:GIBSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:CLAUDIA
Other - Middle Name:VIOLA
Other - Last Name:CAVAGNARO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:33 E WILDER RD
Mailing Address - Street 2:
Mailing Address - City:WEST LEBANON
Mailing Address - State:NH
Mailing Address - Zip Code:03784-3106
Mailing Address - Country:US
Mailing Address - Phone:603-443-0104
Mailing Address - Fax:266-543-0623
Practice Address - Street 1:33 E WILDER RD
Practice Address - Street 2:
Practice Address - City:WEST LEBANON
Practice Address - State:NH
Practice Address - Zip Code:03784-3106
Practice Address - Country:US
Practice Address - Phone:603-443-0104
Practice Address - Fax:866-543-0623
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2013-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH62112080P0008X, 2084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0008XAllopathic & Osteopathic PhysiciansPediatricsNeurodevelopmental Disabilities
No2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology