Organization
ELLIOT PROFESSIONAL SERVICES
Active
Parent organization
ELLIOT PROFESSIONAL SERVICES
Other names
Elliot Pediatric Specialists
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
20 CHAMBERS ROAD, ELLIOT PEDIATRIC SPECIALISTS, HOOKSETT, NH 03106-1826
(603) 647-0052
(603) 626-8016
Mailing address
20 CHAMBERS ROAD, ELLIOT PEDIATRIC SPECIALISTS, HOOKSETT, NH 03106-1826
(603) 647-0052
(603) 626-8016
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RE6661
MEDICARE GROUP
NH
Enumeration date
01/02/2009
Last updated
10/08/2009
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