Healthcare Provider Details

I. General information

NPI: 1396126454
Provider Name (Legal Business Name): INSHA HAQUE D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2015
Last Update Date: 07/27/2020
Certification Date: 07/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 CRESCENT ST.
PENACOOK NH
03303-1412
US

IV. Provider business mailing address

4 CRESCENT ST.
PENACOOK NH
03303-1412
US

V. Phone/Fax

Practice location:
  • Phone: 603-753-4302
  • Fax: 603-227-7570
Mailing address:
  • Phone: 603-753-4302
  • Fax: 603-227-7570

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberRT2841
License Number StateNH
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number20566
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: