Individual
DR. LISA TILLUCKDHARRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
248 PLEASANT ST, SUITE G100, CONCORD, NH 03301-2588
(603) 224-9661
(603) 228-7051
Mailing address
248 PLEASANT ST, SUITE G100, CONCORD, NH 03301-2588
(603) 224-9661
(603) 228-7051
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
14363
NH
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
14363
NH
207RP1001X
Pulmonary Disease Physician
Primary
14363
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1016776
—
VT
05
—
30208990
—
NH
Enumeration date
07/03/2007
Last updated
01/15/2016
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