Individual
TERESA ANN PONN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
185 QUEEN CITY AVE, MANCHESTER, NH 03101-7100
(603) 668-3067
(603) 668-0164
Mailing address
185 QUEEN CITY AVE, ELLIOT BREAST HEALTH CENTER, MANCHESTER, NH 03101-7100
(603) 668-3067
(603) 668-0164
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
13176
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30206042
—
NH
Enumeration date
11/22/2005
Last updated
04/13/2011
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