Healthcare Provider Details

I. General information

NPI: 1275520009
Provider Name (Legal Business Name): REMELINE C DAMASCO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2005
Last Update Date: 04/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

590 COURT ST DARTMOUTH HITCHCOCK - INTERNAL MED
KEENE NH
03431
US

IV. Provider business mailing address

69 ISLAND ST STE C
KEENE NH
03431-3507
US

V. Phone/Fax

Practice location:
  • Phone: 603-354-5400
  • Fax:
Mailing address:
  • Phone: 603-354-5454
  • Fax: 603-354-6704

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number042-0010649
License Number StateVT
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number15404
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: