# ELLIOT PHYSICIANS NETWORK

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** ELLIOT PHYSICIANS NETWORK
- **Other names:** Elliot Family Medicine at Manchester
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1053642892
- **Legal business name:** ELLIOT PHYSICIANS NETWORK
- **Authorized official:** RICHARD P. HERMAN (DIRECTOR OF FINANCE & OPERATIONS)
- **Authorized official phone:** (603) 663-4904

## Contact information

- **Practice address:** 4 ELLIOT WAY, SUITE 100, ELLIOT FAMILY MEDICINE AT MANCHESTER, MANCHESTER, NH 03103-3551
- **Practice address phone:** (603) 626-5113
- **Practice address fax:** (603) 622-5298
- **Mailing address:** 4 ELLIOT WAY, SUITE 100, ELLIOT FAMILY MEDICINE AT MANCHESTER, MANCHESTER, NH 03103-3551
- **Mailing address phone:** (603) 626-5113
- **Mailing address fax:** (603) 622-5298

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/19/2010
- **Last updated:** 10/22/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | RE5600 | MEDICARE GROUP PTAN | NH |