Organization
ELLIOT PROFESSIONAL SERVICES
Active
Parent organization
ELLIOT PROFESSIONAL SERVICES
Other names
EPS Pain Management
Organization subpart
Yes
Provider details
NPI number
Legal business name
ELLIOT PROFESSIONAL SERVICES
Authorized official
RICHARD P. HERMAN (DIRECTOR OF OPERATIONS & FINANCE)
(603) 663-4904
Entity
Organization
Contact information
Practice address
185 QUEEN CITY AVE, PAIN MANAGEMENT - ELLIOT HOSPITAL, MANCHESTER, NH 03101-7100
(603) 663-6730
(603) 663-6538
Mailing address
185 QUEEN CITY AVE, PAIN MANAGEMENT - ELLIOT HOSPITAL, MANCHESTER, NH 03101-7100
(603) 663-6730
(603) 663-6538
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30213577
—
NH
01
—
CK3360
RR MEDICARE
NH
Enumeration date
04/05/2006
Last updated
03/22/2011
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