Healthcare Provider Details

I. General information

NPI: 1538158738
Provider Name (Legal Business Name): ELLEN E BERNARD DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ELLEN DEMARCO

II. Dates (important events)

Enumeration Date: 10/19/2005
Last Update Date: 10/16/2025
Certification Date: 10/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

96 CALEF HWY
EPPING NH
03042-2224
US

IV. Provider business mailing address

4 ALUMNI DR
EXETER NH
03833-2118
US

V. Phone/Fax

Practice location:
  • Phone: 603-693-2100
  • Fax: 603-679-1046
Mailing address:
  • Phone: 603-693-2100
  • Fax: 603-679-1046

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number13236
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: