Organization
GRANITE STATE NEUROSURGERY PLLC
Active
Organization
GRANITE STATE NEUROSURGERY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANNE CHRISTINE TALBOT-KLEEMAN RN (EXECUTIVE DIRECTOR)
(603) 472-8888
Entity
Organization
Contact information
Practice address
4 HAWTHORNE DR, BEDFORD, NH 03110-6912
(603) 472-8888
(603) 472-9090
Mailing address
4 HAWTHORNE DR, BEDFORD, NH 03110-6912
(603) 472-8888
(603) 472-9090
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
—
—
207XS0117X
Orthopaedic Surgery of the Spine Physician
—
—
225100000X
Physical Therapist
—
—
247100000X
Radiologic Technologist
—
—
363AS0400X
Surgical Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30214732
—
NH
01
—
DB3506
RAILROAD MEDICARE
—
Enumeration date
08/22/2006
Last updated
03/20/2008
Update your record
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