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General NPI Number Information
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NPI Number | 1154310910
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Entity Type | Organization
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Legal Business Name | ELLIOT PHYSICIANS NETWORK
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Dates
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Enumeration Date | 10/14/2005
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Last Update Date | 06/20/2008
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Provider Practice Location Address
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Address Line | 15 CONSTITUTION DR ELLIOT FAMILY MEDICINE AT BEDFORD VILLAGE
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City | BEDFORD
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State | NH
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Zip | 03110-6042
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Country | US
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Telephone | 603-472-7233
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Fax | 603-472-9188
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Provider Business Mailing Address
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Address Line | 15 CONSTITUTION DR ELLIOT FAMILY MEDICINE AT BEDFORD VILLAGE
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City | BEDFORD
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State | NH
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Zip | 03110-6042
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Country | US
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Telephone | 603-472-7233
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Fax | 603-472-9188
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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 | 603-663-5766
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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