Organization
WENTWORTH DOUGLASS HOSPITAL
Active
Organization
WENTWORTH DOUGLASS HOSPITAL
Active
Other names
Diabetes Services
Organization subpart
No
Provider details
NPI number
Authorized official
JOEL DEGENAARS (EXECUTIVE DIRECTOR OF FINANCE)
(603) 740-2806
Entity
Organization
Contact information
Practice address
15 OLD ROLLINSFORD RD STE 105, DOVER, NH 03820-2870
(603) 742-5252
Mailing address
PO BOX 412540, BOSTON, MA 02241-2540
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
—
—
163WD0400X
Diabetes Educator Registered Nurse
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
004786
ADA CERTIFICATION
NH
05
—
3074430
—
NH
Enumeration date
06/07/2017
Last updated
12/17/2025
Update your record
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