Provider Demographics
NPI:1699081174
Name:PATRICIA A. LOCURATOLO MD, LLC
Entity type:Organization
Organization Name:PATRICIA A. LOCURATOLO MD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:LOCURATOLO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:603-427-2577
Mailing Address - Street 1:875 GREENLAND RD
Mailing Address - Street 2:SUITE B4
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801
Mailing Address - Country:US
Mailing Address - Phone:603-427-2577
Mailing Address - Fax:603-427-0048
Practice Address - Street 1:875 GREENLAND RD
Practice Address - Street 2:SUITE B4
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801
Practice Address - Country:US
Practice Address - Phone:603-427-2577
Practice Address - Fax:603-427-0048
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-23
Last Update Date:2010-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH79142084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30002490Medicaid
NH30002490Medicaid
NHA14168Medicare UPIN