Healthcare Provider Details

I. General information

NPI: 1154708964
Provider Name (Legal Business Name): JARED DUNAHAY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2015
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 TSIENNETO RD STE 300
DERRY NH
03038-1584
US

IV. Provider business mailing address

6 TSIENNETO RD STE 300
DERRY NH
03038-1584
US

V. Phone/Fax

Practice location:
  • Phone: 603-216-0400
  • Fax: 603-216-3800
Mailing address:
  • Phone: 603-216-0400
  • Fax: 603-216-3800

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number18723
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: