Healthcare Provider Details

I. General information

NPI: 1912925694
Provider Name (Legal Business Name): ANTHONY H PRESUTTI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 03/22/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

590 COURT ST
KEENE NH
03431-1719
US

IV. Provider business mailing address

590 COURT ST
KEENE NH
03431-1719
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License Number12756
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: