PREMISE HEALTH OF CONNECTICUT MEDICAL P.C. NPI 1982373726

NPI Information

PREMISE HEALTH OF CONNECTICUT MEDICAL, P.C. is a multi-specialty clinic center in Manchester, NH. PREMISE HEALTH OF CONNECTICUT MEDICAL, P.C. NPI is 1982373726. The provider is registered as an organization entity type.
The provider Is Doing Business As Bae Systems-manchester.

The provider's business location address is:

3000 GOFFS FALLS RD
MANCHESTER, NH
ZIP 03103-109
Phone: (603) 506-0203
Fax: (603) 506-0204

The provider's authorized official is Jon Leizman .
The authorized official title is President and has the following contact phone number (216) 479-9063.

The CLIA number assigned to this NPI record is 30D2235228 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/7/2021 and was last updated on 8/15/2022.

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:

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