Individual
BRIGETTE BROCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
330 BORTHWICK AVE, SUITE 210, PORTSMOUTH, NH 03801-4174
(603) 433-8733
(603) 433-8834
Mailing address
330 BORTHWICK AVE, SUITE 210, PORTSMOUTH, NH 03801-4174
(603) 433-8733
(603) 433-8834
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0987
NH
363AM0700X
Medical Physician Assistant
2011
MA
363AS0400X
Surgical Physician Assistant
2011
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3094926
—
NH
01
—
P01281398
RAILROAD MEDICARE
NH
Enumeration date
02/28/2007
Last updated
05/09/2014
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