Individual
ELISHA MAGNIFICO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
70 MAIN STREET, SUITE 201, PETERBOROUGH, NH 03458-1238
(603) 924-7722
Mailing address
PO BOX 71, PETERBOROUGH, NH 03458-0071
(603) 924-7722
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1111
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020377315
COMMON TAX ID
NH
01
—
272746
CIGNA
NH
05
—
3074050
—
NH
01
—
561822
AETNA
NH
01
—
626514
HARVARD PILGRIM
NH
01
—
66Y011091NH01
ANTHEM BCBS
NH
01
—
761242
TUFTS
NH
05
—
99560056
—
NH
Enumeration date
01/12/2007
Last updated
08/09/2013
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