Organization
ELLIOT PHYSICIANS NETWORK
Active
Parent organization
ELLIOT PHYSICIANS NETWORK
Other names
Doctors Park Pediatrics
Organization subpart
Yes
Provider details
NPI number
Legal business name
ELLIOT PHYSICIANS NETWORK
Authorized official
RICHARD P. HERMAN (DIRECTOR OF OPERATIONS & FINANCE)
(603) 663-5766
Entity
Organization
Contact information
Practice address
275 MAMMOTH RD STE 2, DOCTORS PARK PEDIATRICS, MANCHESTER, NH 03109-4133
(603) 663-8300
(603) 663-8349
Mailing address
275 MAMMOTH RD STE 2, DOCTORS PARK PEDIATRICS, MANCHESTER, NH 03109-4133
(603) 663-8300
(603) 663-8349
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30210579
—
NH
01
—
CG2227
RR MEDICARE GROUP
NH
Enumeration date
10/26/2005
Last updated
06/20/2008
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