Individual
JYOTSOM BIPIN GANATRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD MPU
Contact information
Practice address
250 RIVER RD, MANCHESTER, NH 03104-2423
(603) 668-2020
(603) 668-0881
Mailing address
250 RIVER RD, MANCHESTER, NH 03104-2423
(603) 668-2020
(603) 668-0881
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
12903
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30205198
—
NH
01
—
954007378NH01
ANTHEM
—
Enumeration date
02/23/2006
Last updated
12/14/2021
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