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ELLIOT PROFESSIONAL SERVICES

Physicians Emergency Medicine

Provider NPI: 1285627935

Organization Information:
Organization Name:  ELLIOT PROFESSIONAL SERVICES
Organization is not Subpart
Authorized Official:  RICHARD P. HERMAN  DIRECTOR OF OPERATIONS & FINANCE  603-663-4904

Practice Location:
1070 HOLT AVE UNIT 1, SUITE 2200 MANCHESTER, NH 03109-5603 US
Tel: 603-663-4900  Fax: 603-663-4984

Business Mailing Address:
PO BOX 9659  MANCHESTER, NH 03108-9659 US
Tel: 603-663-4900  Fax: 603-663-4984

NPI Information:
NPI: 1285627935
Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N207P00000XPhysicians
Emergency Medicine
N2080N0001XPhysicians
Pediatrics
N207RH0002XPhysicians
Internal Medicine
N208200000XPhysicians
Plastic Surgery
N2084P0800XPhysicians
Psychiatry & Neurology
N2084P0804XPhysicians
Psychiatry & Neurology
N208M00000XPhysicians
Hospitalist
N208VP0000XPhysicians
Pain Medicine
N2086S0120XPhysicians
Surgery
N207RP1001XPhysicians
Internal Medicine
N207RE0101XPhysicians
Internal Medicine
Y207R00000XPhysicians
Internal Medicine

Other Provider Identifiers:

IssuerNumberStateType
RR MEDICARE GROUP #CK3360NH01



American Medical Association 2012 taxonomy code information

Code: 207R00000X

Type:

Classification:



Definition:



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