Individual
VICTOR GENNARO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
103 BOULDER POINT DRIVE, PLYMOUTH ORTHOPEDICS AND SPORTS MEDICINE CLINIC, PLYMOUTH, NH 03264-3428
(603) 536-1565
(603) 536-1200
Mailing address
P.O. BOX 706, PLYMOUTH, NH 03264-0706
(603) 481-8757
(603) 238-2163
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
8934
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0019104
ANTHEM
VT
01
—
0400634Y0NH02
ANTHEM
NH
01
—
158488245
TRICARE
NH
01
—
175805800
US DEPARTMENT OF LABOR
NH
01
—
18P031
MVP
NH
01
—
200043876
RAILROAD MEDICARE
NH
05
—
30005795
—
NH
05
—
3070671
—
NH
01
—
3164921
CIGNA
NH
01
—
4483620001
DMERC
NH
01
—
5330990
CCN
NH
05
—
ORE2681
—
VT
01
—
Z51935
ANTHEM
MA
Enumeration date
07/18/2006
Last updated
11/06/2015
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