Basic Information
Provider Information
NPI: 1942242417
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: VALVANO
FirstName: MARY
MiddleName: N
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 250 PLEASANT ST
Address2: EMERGENCY DEPT
City: CONCORD
State: NH
PostalCode: 033017539
CountryCode: US
TelephoneNumber: 6032277000
FaxNumber: 6032307218
Practice Location
Address1: 250 PLEASANT ST
Address2: ER DEPT
City: CONCORD
State: NH
PostalCode: 033017539
CountryCode: US
TelephoneNumber: 6032257000
FaxNumber: 6032307218
Other Information
ProviderEnumerationDate: 06/11/2006
LastUpdateDate: 02/03/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207P00000X10573NHY Allopathic & Osteopathic PhysiciansEmergency Medicine 

No ID Information.


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