Organization
ELLIOT PROFESSIONAL SERVICES
Active
Parent organization
ELLIOT PROFESSIONAL SERVICES
Other names
Greater Pawtuckaway Imaging
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
15 FREETOWN RD, GREATER PAWTUCKAWAY IMAGING, RAYMOND, NH 03077-2358
(603) 895-8000
(603) 895-8099
Mailing address
15 FREETOWN RD, GREATER PAWTUCKAWAY IMAGING, RAYMOND, NH 03077-2358
(603) 895-8000
(603) 895-8099
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15Y002260NH02
ANTHEM GRP ACES
NH
05
—
30812254
—
NH
01
—
3207928
AETNA GRP
NH
01
—
601463704
W/C DOL GRP
NH
01
—
626440
HPHC GRP
NH
01
—
667221
CIGNA GRP
NH
01
—
696696
TUFTS GRP
NH
01
—
P00009327
RR MEDICARE GRP
NH
Enumeration date
02/23/2006
Last updated
07/08/2008
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