Healthcare Provider Details

I. General information

NPI: 1124668546
Provider Name (Legal Business Name): IORA HEALTH NEW HAMPSHIRE, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/14/2020
Last Update Date: 01/14/2020
Certification Date: 01/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 ALLEN ST STE 100
HANOVER NH
03755-2065
US

IV. Provider business mailing address

101 TREMONT ST FL 6
BOSTON MA
02108-5004
US

V. Phone/Fax

Practice location:
  • Phone: 603-738-1164
  • Fax:
Mailing address:
  • Phone: 617-580-0496
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: NEIL PATEL
Title or Position: SR. VP NE MEDICAL DIRECTOR
Credential:
Phone: 617-454-4672