Healthcare Provider Details

I. General information

NPI: 1609035054
Provider Name (Legal Business Name): EMILY P ZEITLER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2008
Last Update Date: 07/11/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ONE MEDICAL CENTER DRIVE CARDIOLOGY
LEBANON NH
03756
US

IV. Provider business mailing address

ONE MEDICAL CENTER DRIVE CARDIOLOGY
LEBANON NH
03756-0001
US

V. Phone/Fax

Practice location:
  • Phone: 603-650-5274
  • Fax:
Mailing address:
  • Phone: 603-650-5274
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number2011-01746
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number18834
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: