Organization
ELLIOT PHYSICIANS NETWORK
Active
Parent organization
ELLIOT PHYSICIANS NETWORK
Other names
Senior Health Primary Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
ELLIOT PHYSICIANS NETWORK
Authorized official
RICHARD P. HERMAN (DIRECTOR OF OPERATIONS AND FINANCE)
(603) 663-4904
Entity
Organization
Contact information
Practice address
138 WEBSTER ST, SENIOR HEALTH PRIMARY CARE, MANCHESTER, NH 03104-2512
(603) 663-7030
(603) 663-7039
Mailing address
138 WEBSTER ST, SENIOR HEALTH PRIMARY CARE, MANCHESTER, NH 03104-2512
(603) 663-7030
(603) 663-7039
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30211704
—
NH
01
—
CG2227
RR MEDICARE GROUP #
NH
Enumeration date
11/08/2005
Last updated
06/20/2008
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