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General NPI Number Information
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NPI Number | 1013006717
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Entity Type | Organization
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Legal Business Name | ELLIOT PROFESSIONAL SERVICES
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Dates
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Enumeration Date | 10/12/2006
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Last Update Date | 06/20/2008
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Provider Practice Location Address
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Address Line | 1 ELLIOT WAY ELLIOT INTENSIVIST PROGRAM
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City | MANCHESTER
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State | NH
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Zip | 03103-3502
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Country | US
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Telephone | 603-663-2231
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Fax | 603-663-2353
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Provider Business Mailing Address
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Address Line | 1 ELLIOT WAY ELLIOT INTENSIVIST PROGRAM
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City | MANCHESTER
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State | NH
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Zip | 03103-3502
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Country | US
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Telephone | 603-663-2231
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Fax | 603-663-2353
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS & FINANCE
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Name | RICHARD P. HERMAN
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Credential |
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Telephone | 603-663-4904
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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