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General NPI Number Information
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NPI Number | 1326278748
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Entity Type | Organization
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Legal Business Name | EDELWEISS FAMILY CARE & TELEHEALTH,LLC
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Dates
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Enumeration Date | 07/20/2009
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Last Update Date | 10/07/2009
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Provider Practice Location Address
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Address Line | 750 CENTRAL AVE SUITE L
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City | DOVER
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State | NH
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Zip | 03820-3434
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Country | US
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Telephone | 603-740-4550
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Fax | 603-740-4551
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Provider Business Mailing Address
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Address Line | 1 ROUTE 236 SUITE 3
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City | KITTERY
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State | ME
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Zip | 03904-5528
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Country | US
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Telephone | 603-740-4550
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Fax | 603-740-4551
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | MRS. EVA M ENZINGER
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Credential | MD
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Telephone | 603-740-4550
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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 | 11732
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License Number State | NH
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