Organization
ELLIOT PROFESSIONAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD P. HERMAN (DIRECTOR OF OPERATIONS & FINANCE)
(603) 663-4904
Entity
Organization
Contact information
Practice address
1070 HOLT AVE, UNIT 1, SUITE 2200, MANCHESTER, NH 03109-5603
(603) 663-4900
(603) 663-4984
Mailing address
PO BOX 9659, MANCHESTER, NH 03108-9659
(603) 663-4900
(603) 663-4984
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
—
—
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
—
—
207RP1001X
Pulmonary Disease Physician
—
—
2080N0001X
Neonatal-Perinatal Medicine Physician
—
—
208200000X
Plastic Surgery Physician
—
—
2084P0800X
Psychiatry Physician
—
—
2084P0804X
Child & Adolescent Psychiatry Physician
—
—
2086S0120X
Pediatric Surgery Physician
—
—
208M00000X
Hospitalist Physician
—
—
208VP0000X
Pain Medicine Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CK3360
RR MEDICARE GROUP #
NH
Enumeration date
08/29/2005
Last updated
06/20/2008
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