Individual
JONATHAN P VACCARO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5 ALUMNI DRIVE, EXETER, NH 03833-2128
(603) 580-6608
(603) 580-6707
Mailing address
PO BOX 1849, LEWISTON, ME 04241-1849
(207) 784-2554
(207) 777-5363
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
11744
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01Y004131NH01
ANTHEM
NH
01
—
1861415457
BMC HEALTHNET PLAN
—
01
—
2373550
CIGNA
—
01
—
300134469
RAILROAD MEDICARE
—
05
—
30203112
—
NH
05
—
3202313
—
MA
05
—
336510099
—
ME
01
—
5082650
AETNA
—
Enumeration date
07/25/2006
Last updated
12/15/2009
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