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Organization
ELLIOT PHYSICIANS NETWORK
Active
Organization
ELLIOT PHYSICIANS NETWORK
Active
Parent organization
ELLIOT PHYSICIANS NETWORK
Other names
Elliot Primary Care at Londonderry
Organization subpart
Yes
Provider details
NPI number
Legal business name
ELLIOT PHYSICIANS NETWORK
Authorized official
RICHARD P. HERMAN (DIRECTOR OF OPERATIONS & FINANCE)
(603) 663-4904
Entity
Organization
Contact information
Practice address
40 BUTTRICK RD, ELLIOT PRIMARY CARE AT LONDONDERRY, LONDONDERRY, NH 03053-3381
(603) 537-2100
(603) 537-2107
Mailing address
40 BUTTRICK RD, ELLIOT PRIMARY CARE AT LONDONDERRY, LONDONDERRY, NH 03053-3381
(603) 537-2100
(603) 537-2107
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
208000000X
Pediatrics Physician
—
NULL
208000000X
Pediatrics Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30210569
—
NH
01
—
CG2227
RR MEDICARE GRP PIN
NH
Enumeration date
10/13/2005
Last updated
06/20/2008
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