Organization
EAR NOSE & THROAT MEDICINE & SURGERY OF PORTSMOUTH PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDMOND Y YEGANEH MD (OWNER/OFFICER)
(603) 431-3477
Entity
Organization
Contact information
Practice address
330 BORTHWICK AVE, SUITE 304, PORTSMOUTH, NH 03801-7109
(603) 431-3477
(603) 430-9663
Mailing address
330 BORTHWICK AVE, SUITE 304, PORTSMOUTH, NH 03801-7109
(603) 431-3477
(603) 430-9663
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
NH5840
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30010589
—
NH
Enumeration date
04/30/2007
Last updated
11/29/2012
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