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Organization

ELLIOT PHYSICIANS NETWORK

Active
Parent organization
ELLIOT PHYSICIANS NETWORK
Other names
Elliot Family Medicine at Manchester
Organization subpart
Yes

Provider details

NPI number
Legal business name
ELLIOT PHYSICIANS NETWORK
Authorized official
RICHARD P. HERMAN (DIRECTOR OF FINANCE & OPERATIONS)
(603) 663-4904
Entity
Organization

Contact information

Practice address
4 ELLIOT WAY, SUITE 100, ELLIOT FAMILY MEDICINE AT MANCHESTER, MANCHESTER, NH 03103-3551
(603) 626-5113
(603) 622-5298
Mailing address
4 ELLIOT WAY, SUITE 100, ELLIOT FAMILY MEDICINE AT MANCHESTER, MANCHESTER, NH 03103-3551
(603) 626-5113
(603) 622-5298

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
RE5600
MEDICARE GROUP PTAN
NH
Enumeration date
01/19/2010
Last updated
10/22/2011
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