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General NPI Number Information
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NPI Number | 1417167792
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Entity Type | Organization
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Legal Business Name | NEUROLOGY ASSOCIATES OF SOUTHERN NH,PA
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Dates
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Enumeration Date | 05/23/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 769 S MAIN ST SUITE 101
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City | MANCHESTER
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State | NH
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Zip | 03102-5166
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Country | US
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Telephone | 603-669-0859
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Fax |
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Provider Business Mailing Address
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Address Line | 769 S MAIN ST SUITE 101
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City | MANCHESTER
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State | NH
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Zip | 03102-5166
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Country | US
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Telephone | 603-669-0859
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Fax |
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Authorized Official
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Title or Position | TREASURER
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Name | DR. DANIEL R BOTSFORD JR.
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Credential | MD
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Telephone | 603-669-0859
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 6124
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License Number State | NH
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 6351
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License Number State | NH
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Taxonomy #3
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 7865
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License Number State | NH
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