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General NPI Number Information
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NPI Number | 1316575046
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Entity Type | Individual
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Provider Name | COLLEEN GERAGHTY MD
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Gender | Female
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Dates
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Enumeration Date | 03/29/2020
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Last Update Date | 08/06/2023
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Provider Practice Location Address
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Address Line | 1 ELLIOT WAY
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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 | 603-669-5300
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Fax |
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Provider Business Mailing Address
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Address Line | 86 BUTTONWOOD RD
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City | BEDFORD
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State | NH
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Zip | 03110-5709
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Country | US
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Telephone | 603-490-4779
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 284618
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 24106
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License Number State | NH
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