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General NPI Number Information
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NPI Number | 1871087619
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Entity Type | Organization
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Legal Business Name | IBIS HEALTH SERVICES-NEW HAMPSHIRE PLLC
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Dates
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Enumeration Date | 06/15/2018
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Last Update Date | 08/21/2023
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Provider Practice Location Address
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Address Line | 24 HEATHROW CT
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City | NASHUA
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State | NH
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Zip | 03063-1524
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Country | US
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Telephone | 603-664-4800
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Fax | 207-401-2727
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Provider Business Mailing Address
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Address Line | 215 AYER RD UNIT 797
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City | HARVARD
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State | MA
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Zip | 01451-5033
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Country | US
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Telephone | 603-664-4800
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Fax | 207-401-2727
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. GARY M JANKO
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Credential |
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Telephone | 603-921-4947
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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