Provider Demographics
NPI:1992064489
Name:PRIMIANO, ERIN ELIZABETH (PA-C)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:ELIZABETH
Last Name:PRIMIANO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:252 BROAD ST
Mailing Address - Street 2:
Mailing Address - City:CLAREMONT
Mailing Address - State:NH
Mailing Address - Zip Code:03743-2636
Mailing Address - Country:US
Mailing Address - Phone:603-542-6455
Mailing Address - Fax:603-543-0736
Practice Address - Street 1:252 BROAD ST
Practice Address - Street 2:
Practice Address - City:CLAREMONT
Practice Address - State:NH
Practice Address - Zip Code:03743-2636
Practice Address - Country:US
Practice Address - Phone:603-542-6455
Practice Address - Fax:603-543-0736
Is Sole Proprietor?:No
Enumeration Date:2012-05-03
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363A00000X
NH1941363AM0700X
VT055.0031131363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT0027610Medicare PIN
VT0027610Medicare PIN