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Organization

ELLIOT PROFESSIONAL SERVICES

Active
Parent organization
ELLIOT PROFESSIONAL SERVICES
Other names
Elliot Emergency Medicine Specialists
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
1 ELLIOT WAY, ELLIOT EMERGENCY MEDICINE SPECIALISTS, MANCHESTER, NH 03103-3502
(603) 663-2830
(603) 663-1849
Mailing address
1 ELLIOT WAY, ELLIOT EMERGENCY MEDICINE SPECIALISTS, MANCHESTER, NH 03103-3502
(603) 663-2830
(603) 663-1849

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
CK3360
RR MEDICARE GROUP PIN
01
RE6661
MEDICARE GROUP PIN
NH
Enumeration date
05/13/2008
Last updated
06/20/2008
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