Individual
DR. TERRI L LALLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
17 OLD ROLLINSFORD RD, DOVER, NH 03820-2827
(603) 742-4048
(603) 743-3345
Mailing address
99 GOODWIN RD, KITTERY POINT, ME 03905-5224
(603) 742-4048
(603) 743-3345
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
8315
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20067Y
ANTHEM PROVIDER NUMBER
NH
05
—
30003620
—
NH
01
—
7001338
AETNA PROVIDER #
NH
01
—
NH1044
HARVARD PILGRAM HEALTH
NH
Enumeration date
05/01/2006
Last updated
07/09/2007
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