Organization
ELLIOT PROFESSIONAL SERVICES
Active
Parent organization
ELLIOT PROFESSIONAL SERVICES
Other names
Marc S. Rubenson, MD
Organization subpart
Yes
Provider details
NPI number
Legal business name
ELLIOT PROFESSIONAL SERVICES
Authorized official
RICHARD P HERMAN (DIRECTOR OF OPERATIONS AND FINANCE)
(603) 663-4904
Entity
Organization
Contact information
Practice address
4 ELLIOT WAY, SUITE 201, MANCHESTER, NH 03103-3547
(603) 623-3836
(603) 623-4611
Mailing address
4 ELLIOT WAY, SUITE 201, MANCHESTER, NH 03103-3547
(603) 623-3836
(603) 623-4611
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CK3360
RR MEDICARE
NH
Enumeration date
09/03/2008
Last updated
09/04/2008
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