Healthcare Provider Details

I. General information

NPI: 1033229422
Provider Name (Legal Business Name): STACEY ANN ABBIS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: STACEY ANN GYNTHER M.D.

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 07/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 E HOLLIS ST
NASHUA NH
03060-2928
US

IV. Provider business mailing address

21 E HOLLIS ST
NASHUA NH
03060-2928
US

V. Phone/Fax

Practice location:
  • Phone: 603-577-4260
  • Fax: 603-577-4354
Mailing address:
  • Phone: 603-577-4260
  • Fax: 603-577-4354

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number12330
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: