ELLIOT PROFESSIONAL SERVICES NPI 1336101534

NPI Information

NPI: 1336101534
Provider Name: ELLIOT PROFESSIONAL SERVICES

Other Name: WOUND MANAGEMENT CENTER

Classification: Surgery - 2086S0122X
Entity Type: Organization

Specialization: Plastic and Reconstructive Surgery

Address:
185 QUEEN CITY AVE
WOUND MANAGEMENT CENTER
MANCHESTER, NH
ZIP 03101
Phone: (603) 663-3630
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ELLIOT PROFESSIONAL SERVICES is a plastic and reconstructive surgery surgery in Manchester, NH. The provider is a surgeon who specializes in plastic and reconstructive surgery. ELLIOT PROFESSIONAL SERVICES NPI is 1336101534. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Other Name Is Wound Management Center.

The provider's business location address is:

185 QUEEN CITY AVE
WOUND MANAGEMENT CENTER
MANCHESTER, NH
ZIP 03101-100
Phone: (603) 663-3630
Fax: (603) 663-3669

The provider's authorized official is Richard P. Herman .
The authorized official title is Director Of Operations & Finance and has the following contact phone number (603) 663-4904.

The enumeration date for this NPI number is 4/4/2006 and was last updated on 3/18/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207PE0005X	Emergency Medicine	Undersea and Hyperbaric Medicine		NEW HAMPSHIRE	No
2	2086S0122X	Surgery	Plastic and Reconstructive Surgery			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	RE6661	MEDICARE ID-TYPE UNSPECIFIED	NEW HAMPSHIRE	MEDICARE GRP
2	30212489	MEDICAID	NEW HAMPSHIRE
3	CK3360	OTHER	NEW HAMPSHIRE	RR MEDICARE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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