Individual
ELLEN C BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
150 MARKETPLACE BLVD UNIT 9, ROCHESTER, NH 03867-4387
(603) 516-4212
Mailing address
PO BOX 412503, BOSTON, MA 02241-2503
(603) 516-4212
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0627
NH
363AS0400X
Surgical Physician Assistant
0627
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3105140
—
NH
Enumeration date
03/13/2007
Last updated
04/16/2025
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