Healthcare Provider Details

I. General information

NPI: 1174693972
Provider Name (Legal Business Name): KATHLEEN MARIE TOIVANEN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/09/2006
Last Update Date: 05/17/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

875 GREENLAND RD ORCHARD PARK, SUITE B11
PORTSMOUTH NH
03801-4164
US

IV. Provider business mailing address

PO BOX 677
RYE NH
03870-0677
US

V. Phone/Fax

Practice location:
  • Phone: 603-436-2667
  • Fax: 603-436-2673
Mailing address:
  • Phone: 603-436-2667
  • Fax: 603-436-2673

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number7106
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: