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General NPI Number Information
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NPI Number | 1538650650
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Entity Type | Organization
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Legal Business Name | BLUESTONE HEALTHCARE SERVICES L.L.C.
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Dates
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Enumeration Date | 05/24/2018
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Last Update Date | 05/24/2018
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Provider Practice Location Address
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Address Line | BLUESTONE HEALTHCARE SERVICES LLC 169 SOUTH RIVER RD
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City | BEDFORD
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State | NH
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Zip | 03103
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Country | US
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Telephone | 603-424-5054
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Fax |
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Provider Business Mailing Address
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Address Line | 81 MORGEN DR
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City | AUBURN
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State | NH
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Zip | 03032-3936
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Country | US
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Telephone | 603-424-5054
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Fax |
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | DANIEL M FRAZEE
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Credential | PA-C
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Telephone | 603-424-5054
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0519
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License Number State | NH
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