Provider Demographics
NPI:1427270867
Name:CARBONE, VICTOR NICKOLAS JR (PT)
Entity type:Individual
Prefix:MR
First Name:VICTOR
Middle Name:NICKOLAS
Last Name:CARBONE
Suffix:JR
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3 CAMEO CT
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:NH
Mailing Address - Zip Code:03032-3745
Mailing Address - Country:US
Mailing Address - Phone:603-669-1449
Mailing Address - Fax:
Practice Address - Street 1:769 S MAIN ST
Practice Address - Street 2:SUITE 201
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03102-5166
Practice Address - Country:US
Practice Address - Phone:603-641-6700
Practice Address - Fax:603-623-3611
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1207225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist