Healthcare Provider Details

I. General information

NPI: 1760802938
Provider Name (Legal Business Name): DAVID PISKOROWSKI D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/25/2014
Last Update Date: 03/08/2023
Certification Date: 03/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

246 PLEASANT ST. MEMORIAL BUILDING, WEST, GROUND FLOOR
CONCORD NH
03301-2548
US

IV. Provider business mailing address

246 PLEASANT ST. MEMORIAL BUILDING, WEST, GROUND FLOOR
CONCORD NH
03301-2548
US

V. Phone/Fax

Practice location:
  • Phone: 603-224-9661
  • Fax: 603-227-7528
Mailing address:
  • Phone: 603-224-9661
  • Fax: 603-227-7528

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number23809
License Number StateNH
# 2
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number5151010631
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number4147
License Number StateTN
# 4
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number23809
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: