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NPI Code Detail

MEDICARE: DR. SUSAN HASKELL O.D.

MEDICARE: DR. SUSAN HASKELL O.D.
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
1152W00000XOptometrist0543NH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1821091877
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SUSAN HASKELL O.D.
Provider Business Mailing Address
First Line : 65 BELKNAP ST
Second Line : STE 1
City : DOVER
State : NH
Zip : 03820-3643
Country : US
Telephone Number : 603-742-5719
Fax Number : 603-743-5811
Provider Business Practice Location Address
First Line : 155 BORTHWICK AVE
Second Line : SUITE 200 EAST
City : PORTSMOUTH
State : NH
Zip : 03801-7156
Country : US
Telephone Number : 603-436-1773
Fax Number : 603-427-0655
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2005
Last Update Date : 08/02/2018

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