Organization
ELLIOT PHYSICIANS NETWORK
Active
Parent organization
ELLIOT PHYSICIANS NETWORK
Other names
Pediatric Health Associates
Organization subpart
Yes
Provider details
NPI number
Legal business name
ELLIOT PHYSICIANS NETWORK
Authorized official
RICHARD P. HERMAN (DIRECTOR OF OPERATIONS & FINANCE)
(603) 663-4904
Entity
Organization
Contact information
Practice address
275 MAMMOTH RD STE 1, PEDIATRIC HEALTH ASSOCIATES, MANCHESTER, NH 03109-4133
(603) 663-8350
(603) 663-8399
Mailing address
275 MAMMOTH RD STE 1, PEDIATRIC HEALTH ASSOCIATES, MANCHESTER, NH 03109-4133
(603) 663-8350
(603) 663-8399
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30210585
—
NH
01
—
CG2227
RR MEDICARE GROUP #
NH
Enumeration date
11/02/2005
Last updated
06/20/2008
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