Individual
DR. AIDA CERUNDOLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1 MEDICAL CENTER DR, LEBANON, NH 03756
(603) 650-7254
Mailing address
1 MEDICAL CENTER DR, LEBANON, NH 03756-0001
(603) 650-7254
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
11986
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110004423A
—
MA
01
—
1265497697
ANTHEM BCBS
NH
05
—
30203570
—
NH
01
—
AA188476
HARVARD PILGRIM HEALTHCARE
NH
Enumeration date
04/19/2006
Last updated
09/20/2019
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