Organization
ELLIOT PHYSICIANS NETWORK
Active
Organization
ELLIOT PHYSICIANS NETWORK
Active
Parent organization
ELLIOT PHYSICIANS NETWORK
Other names
Elliot Bay Medical Associates
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
4 ELLIOT WAY STE 102, ELLIOT BAY MEDICAL ASSOCIATES, MANCHESTER, NH 03103-3551
(603) 626-5900
(603) 625-2180
Mailing address
4 ELLIOT WAY STE 102, ELLIOT BAY MEDICAL ASSOCIATES, MANCHESTER, NH 03103-3551
(603) 626-5900
(603) 625-2180
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30216443
—
NH
01
—
CG2227
RR MEDICARE
NH
Enumeration date
02/26/2008
Last updated
06/20/2008
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