STACEY EDGAR (NPI# 1073135885) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073135885 |
| Entity Type | Individual |
| Full Name | STACEY EDGAR |
| Credential | SLS |
| Practice Address |
112 Reservoir Ave Manchester NH 03104-4468 |
| Mailing Address |
20 Hecker St Manchester NH 03102-3975 |
| Practice Telephone | 6036246352 |
| Mailing Telephone | 6036243600 |
| Enumeration Date | 2020-05-14 |
| Last Update Date | 2020-05-14 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 235500000X | Specialist/Technologist | 71891 | NH | Speech, Language and Hearing Service Providers |
| Street Address |
112 RESERVOIR AVE |
| City | MANCHESTER |
| State | NH |
| Zip Code | 03104-4468 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730675562 | Hannah E Boutselis | Nurse Practitioner | 1750 Elm St., Suite 201a, Manchester, NH 03104 | 2018-07-04 |
| 1366948770 | Families In Transition | Counselor | 15 Brook St, Manchester, NH 03104 | 2018-04-04 |
| 1528586872 | Nicole Mitchell | Physical Therapy Assistant | 235 Myrtle St., Manchester, NH 03104 | 2017-09-07 |
| 1851819270 | Community House Calls LLC | Contractor | 497 Hooksett Road, 232, Manchester, NH 03104 | 2017-09-06 |
| 1407207533 | Brianna Cassidy | Specialist/Technologist | 62 Jonathan Ln, Manchester, NH 03104 | 2016-06-30 |
| 1477926871 | Anthony Macri | Skilled Nursing Facility | 524 Blevens Dr., Manchester, NH 03104 | 2015-11-06 |
| 1225412935 | Families In Transition | Counselor | 136 Lowell St, Manchester, NH 03104 | 2015-07-13 |
| 1386036622 | Phoenix Rising Counseling Services, LLC | Counselor | 114 Bay Street, Suite A, Manchester, NH 03104 | 2015-02-24 |
| 1366795767 | Alicia M. Kleczkowski | Nurse Practitioner | 57 Webster St., Manchester, NH 03104 | 2012-10-23 |
| 1356615710 | Laurie Lagasse | Physical Therapy Assistant | 44 West Webster St, Manchester, NH 03104 | 2012-03-02 |
| Find all providers in zip 03104 | ||||
| Taxonomy Code | 235500000X |
| Grouping | Speech, Language and Hearing Service Providers |
| Classification | Specialist/Technologist |
| General classification identifying individuals who are trained on a specific piece of equipment or technical procedure. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881884641 | Buckland Ear Nose & Throat LLC | Specialist/Technologist | 360 Tolland Tpke, Suiter 1e, Manchester, CT 06042-1771 | 2007-07-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881109213 | Linda Beliveau | Specialist/Technologist | 367 Riverdale Rd, Weare, NH 03281-5546 | 2017-12-07 |
| City | MANCHESTER |
| Zip Code | 03104 |
Please comment or provide details below to improve the information on STACEY EDGAR.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.