Healthcare Provider Details

I. General information

NPI: 1558323527
Provider Name (Legal Business Name): SERAPHINE AURELIE THERMITUS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2006
Last Update Date: 09/26/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

444 NASHUA ST
MILFORD NH
03055-4915
US

IV. Provider business mailing address

PO BOX 808
NASHUA NH
03061-0808
US

V. Phone/Fax

Practice location:
  • Phone: 603-673-3870
  • Fax:
Mailing address:
  • Phone: 603-578-5054
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number15839
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: