Healthcare Provider Details

I. General information

NPI: 1740828003
Provider Name (Legal Business Name): MEGHAN CONNOLLY RRT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2019
Last Update Date: 12/18/2019
Certification Date: 12/18/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

70 BUTLER ST
SALEM NH
03079-3925
US

IV. Provider business mailing address

83 MAIN ST
PLAISTOW NH
03865-3010
US

V. Phone/Fax

Practice location:
  • Phone: 603-893-2900
  • Fax:
Mailing address:
  • Phone: 603-235-7996
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License Number1493
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: