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General NPI Number Information
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NPI Number | 1659775575
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Entity Type | Organization
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Legal Business Name | CONCORD OPHTHALMOLOGIC ASSOCIATES PA
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Dates
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Enumeration Date | 10/21/2014
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Last Update Date | 10/21/2014
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Provider Practice Location Address
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Address Line | 248 PLEASANT ST SUITE 1600
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City | CONCORD
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State | NH
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Zip | 03301-2588
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Country | US
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Telephone | 603-224-2020
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Fax |
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Provider Business Mailing Address
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Address Line | 2 PILLSBURY ST SUITE 100
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City | CONCORD
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State | NH
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Zip | 03301-3523
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Country | US
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Telephone | 603-228-1104
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Fax | 603-228-7061
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Authorized Official
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Title or Position | OWNER
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Name | ANDRE A D'HEMECOURT
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Credential | M.D.
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Telephone | 603-228-1104
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 6873
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License Number State | NH
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