Individual
AMY LEWIS HENNESSY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
250 RIVER RD, MANCHESTER, NH 03104-2423
(603) 668-2020
(603) 668-0881
Mailing address
250 RIVER RD, MANCHESTER, NH 03104-2423
(603) 668-2020
(603) 668-0881
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
17007
NH
207WX0009X
Glaucoma Specialist (Ophthalmology) Physician
17007
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
019616900
—
MD
01
—
123130
GEISINGER HEALTH PLAN
MD
01
—
93408502
BC BS
MD
01
—
DH0987
MEDICARE RAILROAD
MD
Enumeration date
05/21/2007
Last updated
07/21/2022
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