Organization
ELLIOT PROFESSIONAL SERVICES
Active
Organization
ELLIOT PROFESSIONAL SERVICES
Active
Parent organization
ELLIOT PROFESSIONAL SERVICES
Other names
Elliot Pulmonary Medicine
Organization subpart
Yes
Provider details
NPI number
Legal business name
ELLIOT PROFESSIONAL SERVICES
Authorized official
RICHARD P HERMAN (DIRECTOR OF OPERATIONS AND FINANCE)
(603) 663-4904
Entity
Organization
Contact information
Practice address
185 QUEEN CITY AVENUE, ELLIOT PULMONARY MEDICINE, MANCHESTER, NH 03101-7100
(603) 663-3770
(603) 663-3779
Mailing address
185 QUEEN CITY AVENUE, ELLIOT PULMONARY MEDICINE, MANCHESTER, NH 03101-7100
(603) 663-3770
(603) 663-3779
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30216644
—
NH
01
—
CK3360
RR MEDICARE
—
Enumeration date
05/21/2008
Last updated
04/01/2011
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