Organization
COTTAGE ORTHOPEDICS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICTOR GENNARO DO (OWNER)
(603) 747-3668
Entity
Organization
Contact information
Practice address
15 TOWN WEST RD, PLYMOUTH, NH 03264-3428
(603) 536-1565
(603) 536-1200
Mailing address
PO BOX 32, ANDOVER, NH 03216-0032
(603) 735-6060
(603) 735-6070
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
8934
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1008820
—
VT
01
—
175805800
US DEPARTMENT OF LABOR
NH
01
—
200002520
MVP
NH
05
—
30232107
—
NH
01
—
4483620001
DMERC
NH
01
—
CJ7687
RAILROAD MEDICARE
NH
01
—
ZCA707
ANTHEM
MA
Enumeration date
07/11/2006
Last updated
06/10/2008
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