Organization
ASSOCIATES IN SURGERY & GASTROENTEROLOGY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JYL BRADLEY MS, FACMPE (ADMINISTRATOR)
(603) 543-3501
Entity
Organization
Contact information
Practice address
7 DUNNING ST, CLAREMONT, NH 03743-2016
(603) 543-3501
(603) 542-6486
Mailing address
7 DUNNING ST, CLAREMONT, NH 03743-2016
(603) 543-3501
(603) 542-6486
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
—
208600000X
Surgery Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00000328
—
NH
05
—
0003879
—
VT
01
—
50Y387900NH01
ANTHEM BLUE SHIELD
NH
01
—
ASSO00003879
VERMONT BLUE SHIELD
VT
01
—
CB1449
RAILROAD MEDICARE
NH
Enumeration date
04/27/2006
Last updated
12/07/2007
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