Healthcare Provider Details

I. General information

NPI: 1033135967
Provider Name (Legal Business Name): JEFFREY ROBERT HARNSBERGER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 07/19/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 HITCHCOCK WAY
MANCHESTER NH
03104-4125
US

IV. Provider business mailing address

100 HITCHCOCK WAY
MANCHESTER NH
03104-4125
US

V. Phone/Fax

Practice location:
  • Phone: 603-695-2840
  • Fax: 603-695-2985
Mailing address:
  • Phone: 603-695-2840
  • Fax: 603-695-2985

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number9041
License Number StateNH
# 2
Primary TaxonomyY
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number9041
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: