ROWELLA LICUP SIRBILADZE (NPI# 1194907279) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194907279 |
| Entity Type | Individual |
| Full Name | ROWELLA LICUP SIRBILADZE |
| Other Name | ROWELLA MENDOZA LICUP |
| Credential | MD |
| Practice Address |
25 Leavey Dr Bedford NH 03110-4437 |
| Mailing Address |
14 Bills Way Bedford NH 03110-4349 |
| Practice Telephone | 6036633740 |
| Mailing Telephone | 2032972223 |
| Enumeration Date | 2007-11-30 |
| Last Update Date | 2020-01-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 46347 | TN | Allopathic & Osteopathic Physicians |
| Y | 207RE0101X |
Internal Medicine Specialization: Endocrinology, Diabetes & Metabolism |
46347 | TN | Allopathic & Osteopathic Physicians |
| Street Address |
25 LEAVEY DR |
| City | BEDFORD |
| State | NH |
| Zip Code | 03110-4437 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205033990 | Andrea H Greenfeld | Internal Medicine | 25 Leavey Dr, Bedford, NH 03110 | 2007-06-27 |
| 1356822803 | Lisa Spurrell | Counselor | 25 Leavey Dr, Bedford, NH 03110-4437 | 2018-08-23 |
| 1326592890 | Christine Christophersen | Registered Nurse | 25 Leavey Dr, Bedford, NH 03110 | 2016-08-12 |
| 1578927976 | Sashka Luque | Pediatrics | 25 Leavey Dr, Bedford, NH 03110 | 2016-04-12 |
| 1760896849 | Douglas Michael Phelan | Family Medicine | 25 Leavey Dr, Bedford, NH 03110-4437 | 2014-06-17 |
| 1598032641 | Aimee Margaret Arsenian | Counselor | 25 Leavey Dr, Bedford, NH 03110-4437 | 2011-11-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114587300 | Jillian Lee Grosse | Dietitian, Registered | 80 Palomino Lane Nutrition In Motion, LLC, Suite 101, Bedford, NH 03110 | 2019-06-19 |
| 1154892909 | Artemis Clinic | Acupuncturist | 288 South River Road, Bldg A, Unit 1, Bedford, NH 03110 | 2018-12-05 |
| 1942790217 | Wendy Arleen Williams | Acupuncturist | 360 Route 101 Bldg. 1, Suite E, Bedford, NH 03110 | 2018-05-13 |
| 1336638352 | Elliot Hospital of The City of Manchester | Pharmacy | 25 Leavy Dr, Bedford, NH 03110 | 2018-05-04 |
| 1588182034 | Camille Redmond | Nutritionist | 360 Route 101 Suite 3 A, Bedford, NH 03110 | 2017-09-05 |
| 1750837092 | Katya Kudryavtseva | Acupuncturist | 288 South River Rd, Bldg A, Unit 1, Bedford, NH 03110 | 2016-08-28 |
| 1003268004 | Bethany Heidemann | Occupational Therapist | 66 Hawthorne Dr S, Bedford, NH 03110 | 2016-07-01 |
| 1477913044 | Ultraflex Systems Inc. | Durable Medical Equipment & Medical Supplies | 150 Constitution Drive, 1st Floor, Bedford, NH 03110 | 2016-02-25 |
| 1508243676 | Lydia Ann Nickerson | Dental Hygienist | 4 Bell Hill Rd., Bedford, NH 03110 | 2015-04-28 |
| 1629477021 | Convenientmd LLC | Clinic/Center | 3 Nashua Rd, Bedford, NH 03110 | 2014-08-21 |
| Find all providers in zip 03110 | ||||
| Taxonomy Code | 207RE0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Endocrinology, Diabetes & Metabolism |
| An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124233846 | Vani Kotha | Internal Medicine | 1615 Hospital Pkwy Ste 202, Bedford, TX 76022-5935 | 2007-05-14 |
| 1356554281 | Neeraja Jagannadham Boddu | Internal Medicine | 2921 Brown Trl Ste 130, Bedford, TX 76021-4185 | 2007-05-07 |
| 1740216894 | Shrinivas S. Habbu | Internal Medicine | 2921 Brown Trail, Bedford, TX 76021 | 2006-06-23 |
| 1508335605 | Bedford Endocrinology Pllc | Internal Medicine | 1615 Hospital Pkwy Ste 202, Bedford, TX 76022-5935 | 2018-11-19 |
| 1831666460 | Tarrant Endocrine Associates, Pllc | Internal Medicine | 1615 Hospital Pkwy Ste 202, Bedford, TX 76022-5935 | 2018-11-01 |
| 1558517193 | Madhuri Devdhar | Internal Medicine | 1615 Hospital Pkwy, Ste 202, Bedford, TX 76022-5935 | 2008-08-14 |
| 1245345172 | Toby Judith Briskin | Internal Medicine | 19999 Rockside Rd, Bedford, OH 44146-2074 | 2006-08-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093058919 | Dylan Thomas | Internal Medicine | 10 Members Way Ste 400, Dover, NH 03820 | 2013-03-28 |
| 1144560483 | Robert C. Kolodny | Internal Medicine | 57 The Flume, Amherst, NH 03031-1520 | 2013-02-24 |
| 1265598452 | George Nield Mercer | Internal Medicine | 11 Willow Spring Cir, Hanover, NH 03755-2901 | 2006-12-29 |
| 1487617262 | Margarita Rosa Ochoa-maya | Internal Medicine | 196 Bridge St, Suite 103, Manchester, NH 03104-4953 | 2006-04-11 |
| 1407231525 | Nneka Iroka | Internal Medicine | 1 Elliot Way, Manchester, NH 03103-3502 | 2015-07-30 |
| 1396187787 | Sanaa S Ayyoub | Internal Medicine | 100 Hitchcock Way, Dartmouth Hitchcock - Endocrinology, Manchester, NH 03104 | 2013-07-25 |
| 1861836116 | Michelle June Campbell | Internal Medicine | 1 Elliot Way, Manchester, NH 03103-3502 | 2013-04-17 |
| 1619247111 | Thyroid Center of New Hampshire PC | Internal Medicine | 5 Coliseum Ave, Nashua, NH 03063-3206 | 2011-12-31 |
| 1992000103 | The Memorial Hospital | Internal Medicine | 3073 White Mountain Hwy, North Conway, NH 03860-7101 | 2011-01-19 |
| 1699070995 | Advanced Health and Wellbeing | Internal Medicine | 196 Bridge St, Suite 103, Manchester, NH 03104-4953 | 2011-01-18 |
| Find all providers with the same taxonomy | ||||
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| 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.