Healthcare Provider Details

I. General information

NPI: 1245650993
Provider Name (Legal Business Name): NORTHEAST TMS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/21/2014
Last Update Date: 11/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 FIFTH ST
DOVER NH
03820-2950
US

IV. Provider business mailing address

16 FIFTH ST
DOVER NH
03820-2950
US

V. Phone/Fax

Practice location:
  • Phone: 603-749-4462
  • Fax: 603-749-2475
Mailing address:
  • Phone: 603-749-4462
  • Fax: 603-749-2475

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. RICHARD NAIMARK
Title or Position: PARTNER
Credential: M.D.
Phone: 603-749-4462