Individual
DR. JASON RAFAELE MANGIARDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
85 SPRING ST, LACONIA, NH 03246-3113
(603) 524-7402
Mailing address
85 SPRING ST, LACONIA, NH 03246-3113
(603) 524-7402
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
14738
NH
207Y00000X
Otolaryngology Physician
2484851
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3077636
—
NH
Enumeration date
07/25/2007
Last updated
08/31/2020
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