Organization
ELLIOT PROFESSIONAL SERVICES
Active
Parent organization
ELLIOT PROFESSIONAL SERVICES
Other names
Elliot Intensivist Program
Organization subpart
Yes
Provider details
NPI number
Legal business name
ELLIOT PROFESSIONAL SERVICES
Authorized official
RICHARD P. HERMAN (DIRECTOR OF OPERATIONS & FINANCE)
(603) 663-4904
Entity
Organization
Contact information
Practice address
1 ELLIOT WAY, ELLIOT INTENSIVIST PROGRAM, MANCHESTER, NH 03103-3502
(603) 663-2231
(603) 663-2353
Mailing address
1 ELLIOT WAY, ELLIOT INTENSIVIST PROGRAM, MANCHESTER, NH 03103-3502
(603) 663-2231
(603) 663-2353
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30234596
—
NH
01
—
CK3360
RR MEDICARE
NH
Enumeration date
10/12/2006
Last updated
06/20/2008
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