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NPI Code Detail

MEDICARE: JYOTSOM BIPIN GANATRA MD MPU

MEDICARE: JYOTSOM BIPIN GANATRA MD MPU
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207W00000XOphthalmology Physician12903NH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1954007378NH01OTHERANTHEM
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1033185772
Entity Type Code : Individual
Provider Name (Legal Business Name) : JYOTSOM BIPIN GANATRA MD MPU
Provider Business Mailing Address
First Line : 250 RIVER RD
Second Line :
City : MANCHESTER
State : NH
Zip : 03104-2423
Country : US
Telephone Number : 603-668-2020
Fax Number : 603-668-0881
Provider Business Practice Location Address
First Line : 250 RIVER RD
Second Line :
City : MANCHESTER
State : NH
Zip : 03104-2423
Country : US
Telephone Number : 603-668-2020
Fax Number : 603-668-0881
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/23/2006
Last Update Date : 12/14/2021

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