Healthcare Provider Details

I. General information

NPI: 1659341006
Provider Name (Legal Business Name): HARVARD PILGRIM HEALTH CARE OF NEW ENGLAND
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2006
Last Update Date: 03/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

173 DANIEL WEBSTER HWY
NASHUA NH
03060-5224
US

IV. Provider business mailing address

173 DANIEL WEBSTER HWY
NASHUA NH
03060-5224
US

V. Phone/Fax

Practice location:
  • Phone: 603-891-4400
  • Fax: 603-891-4410
Mailing address:
  • Phone: 603-891-4400
  • Fax: 603-891-4410

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. KATHY GRINLEY
Title or Position: ADMINISTRATOR
Credential:
Phone: 603-891-4412