Organization
COASTAL NEW HAMPSHIE NEUROSURGEONS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SUZETTE PROFIO (PRACTICE MANAGER)
(603) 433-4666
Entity
Organization
Contact information
Practice address
44 BIRCH ST, SUITE 207, DERRY, NH 03038-2752
(603) 433-4666
(603) 433-1338
Mailing address
330 BORTHWICK AVE, SUITE 108, PORTSMOUTH, NH 03801-4174
(603) 433-4666
(603) 433-1338
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
80009465
—
NH
Enumeration date
10/16/2007
Last updated
10/16/2007
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