Provider Demographics
NPI:1215939715
Name:RESCIGNO, JOHN A
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:A
Last Name:RESCIGNO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:JOHN
Other - Middle Name:A
Other - Last Name:RESCIGNO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:6 TSIENNETO RD
Mailing Address - Street 2:SUITE 302
Mailing Address - City:DERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03038-1584
Mailing Address - Country:US
Mailing Address - Phone:603-434-3525
Mailing Address - Fax:603-434-2877
Practice Address - Street 1:6 TSIENNETO RD
Practice Address - Street 2:SUITE 302
Practice Address - City:DERRY
Practice Address - State:NH
Practice Address - Zip Code:03038-1584
Practice Address - Country:US
Practice Address - Phone:603-434-3525
Practice Address - Fax:603-434-2877
Is Sole Proprietor?:No
Enumeration Date:2005-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH116392084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30203981Medicaid
NH30203981Medicaid
NHRE6677Medicare ID - Type Unspecified