Healthcare Provider Details

I. General information

NPI: 1144277872
Provider Name (Legal Business Name): RALPH S ALBERTINI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 E SOUTH ST
HANOVER NH
03755-2148
US

IV. Provider business mailing address

PO BOX 25
THETFORD VT
05074-0025
US

V. Phone/Fax

Practice location:
  • Phone: 603-643-6765
  • Fax:
Mailing address:
  • Phone: 603-643-6765
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number70724
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: