Healthcare Provider Details

I. General information

NPI: 1134368533
Provider Name (Legal Business Name): STEPHEN J LITTLE M.ED.,BC-HIS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/10/2009
Last Update Date: 02/10/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 ISLINGTON ST SUITE 6
PORTSMOUTH NH
03801-4263
US

IV. Provider business mailing address

100 ISLINGTON ST SUITE 6
PORTSMOUTH NH
03801-4263
US

V. Phone/Fax

Practice location:
  • Phone: 603-433-4488
  • Fax: 603-766-6319
Mailing address:
  • Phone: 603-433-4488
  • Fax: 603-766-6319

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberH345
License Number StateNH
# 2
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberDL352
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: