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Organization

ELLIOT PROFESSIONAL SERVICES

Active
Parent organization
ELLIOT PROFESSIONAL SERVICES
Other names
Elliot Neurology Associates
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
185 QUEEN CITY AVE, ELLIOT NEUROLOGY ASSOCIATES, MANCHESTER, NH 03101-7100
(603) 669-0859
(603) 644-3391
Mailing address
185 QUEEN CITY AVE, ELLIOT NEUROLOGY ASSOCIATES, MANCHESTER, NH 03101-7100
(603) 669-0859
(603) 644-3391

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
CK3360
RR MEDICARE
NH
Enumeration date
06/25/2008
Last updated
03/18/2011
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