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Organization
DERRY MEDICAL CENTER, PA
Active
Organization
DERRY MEDICAL CENTER, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TONYA LYN WILSON (BILLING/CREDENTIALING MANAGER)
(603) 537-1317
Entity
Organization
Contact information
Practice address
6 TSIENNETO RD, SUITE 100, DERRY, NH 03038-1584
(603) 537-1300
(603) 537-1326
Mailing address
14B TSIENNETO RD, DERRY, NH 03038-1560
(603) 537-1300
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
—
NULL
133V00000X
Registered Dietitian
—
—
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
NULL
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
207QS0010X
Sports Medicine (Family Medicine) Physician
—
NULL
207QS0010X
Sports Medicine (Family Medicine) Physician
—
—
207RN0300X
Nephrology Physician
—
NULL
207RN0300X
Nephrology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
709488
TUFTS
NH
05
—
83019373
—
NH
Enumeration date
07/07/2006
Last updated
04/15/2026
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