Individual
DR. IVAN VON HACK-PRESTINARY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1 ELLIOT WAY, MANCHESTER, NH 03103-3599
(603) 669-5300
Mailing address
1 ELLIOT WAY, MANCHESTER, NH 03103-3502
(603) 663-2710
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
21808
NH
207R00000X
Internal Medicine Physician
MD.41957
AL
208000000X
Pediatrics Physician
21808
NH
208000000X
Pediatrics Physician
MD.41957
AL
Other
Enumeration date
04/05/2017
Last updated
08/06/2021
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