ELLIOT PROFESSIONAL SERVICES (NPI# 1528389780) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528389780 |
| Entity Type | Organization |
| Organization Name | ELLIOT PROFESSIONAL SERVICES |
| Other Organization Name | NICU FOLLOW UP PROGRAM |
| Practice Address |
275 Mammoth Rd Suite 1c Manchester NH 03109-4133 |
| Practice Telephone | 6036634539 |
| Practice Fax Number | 6036633982 |
| Mailing Telephone | 6036634539 |
| Mailing Fax Number | 6036633982 |
| Enumeration Date | 2010-06-22 |
| Last Update Date | 2010-06-22 |
| Authorized Official Name | RICHARD P. HERMAN (DIRECTOR OF OPERATIONS AND FINANCE) |
| Authorized Official Telephone | 6036634904 |
| Is Organization Subpart | Y |
| Parent Organization Name | ELLIOT PROFESSIONAL SERVICES |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080N0001X |
Pediatrics Specialization: Neonatal-Perinatal Medicine |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NH | MEDICARE GROUP | RE6661 | 01 |
| Other Name | Type Code |
|---|---|
| NICU Follow Up Program | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780975953 | Elliot Professional Services | Obstetrics & Gynecology | 15 Nelson St Fl 2, Elliot Obstetrics and Gynecology, Manchester, NH 03103-2706 | 2011-04-22 |
| 1598054389 | Elliot Professional Services | Pediatrics | 275 Mammoth Rd, Suite 1, Elliot Pediatric Gastroenterology, Manchester, NH 03109-4126 | 2011-04-01 |
| 1548442213 | Elliot Professional Services | Internal Medicine | 33 S Commercial St Ste 401, Elliot Palliative Care Services, Manchester, NH 03101-2626 | 2007-12-04 |
| 1669431466 | Elliot Professional Services | Psychiatry & Neurology | 445 Cypress St Ste 8, Elliot Behavioral Health Services, Manchester, NH 03103-3600 | 2006-03-21 |
| 1386610020 | Elliot Professional Services | Internal Medicine | One Elliot Way, Hospitalist Program, Manchester, NH 03103 | 2006-02-23 |
| 1568438349 | Elliot Professional Services | Radiology | Meeting Place Plaza 199 - Route 101, Greater Amherst Imaging, Amherst, NH 03031 | 2006-02-23 |
| 1285627935 | Elliot Professional Services | Emergency Medicine | 1070 Holt Ave, Unit 1, Suite 2200, Manchester, NH 03109-5603 | 2005-08-29 |
| 1912255118 | Elliot Professional Services | Dermatology | 185 Queen City Ave, Elliot Dermatology, Manchester, NH 03101-7121 | 2012-08-17 |
| 1104187442 | Elliot Professional Services | Urology | 275 Mammoth Rd Ste 1, Elliot Pediatric Urology, Manchester, NH 03109-4133 | 2012-06-04 |
| 1093072407 | Elliot Professional Services | Obstetrics & Gynecology | 1 Elliot Way, Elliot Maternal Fetal Medicine, Manchester, NH 03103-3502 | 2012-04-23 |
| Street Address |
275 MAMMOTH RD SUITE 1C |
| City | MANCHESTER |
| State | NH |
| Zip Code | 03109-4133 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114913142 | Steven B Schwartz | Internal Medicine | 275 Mammoth Rd, Suite 4, Manchester, NH 03109-4133 | 2005-09-26 |
| 1891054490 | Suzanne Marie Vance | Nurse Practitioner | 275 Mammoth Rd, Suite 1, Manchester, NH 03109-4133 | 2012-05-16 |
| 1871797985 | Kathleen Wiley | Nurse Practitioner | 275 Mammoth Rd, Suite 3, Manchester, NH 03109-4133 | 2007-06-13 |
| 1124230370 | Mark Ferlan | Internal Medicine | 275 Mammoth Rd, Suite 4, Manchester, NH 03109-4133 | 2007-05-03 |
| 1508080391 | Elliot Hospital | General Acute Care Hospital | 275 Mammoth Rd, Suite 3, Manchester, NH 03109-4133 | 2007-04-12 |
| 1164457560 | Harohalli R Shashidhar | Pediatrics | 275 Mammoth Rd, Suite 1, Manchester, NH 03109-4133 | 2006-07-12 |
| 1821050337 | Ann Jeffers-brown | Genetic Counselor, MS | 275 Mammoth Rd, Suite 1, Manchester, NH 03109-4133 | 2006-04-03 |
| 1114908894 | Christina L. Ferreri | Nurse Practitioner | 275 Mammoth Rd, Suite #1, Manchester, NH 03109-4133 | 2005-11-09 |
| 1093706418 | Holly P. Mintz | Pediatrics | 275 Mammoth Rd, Suite #1, Manchester, NH 03109-4133 | 2005-11-03 |
| 1518958941 | Mary E. Pulaski | Pediatrics | 275 Mammoth Rd, Suite #1, Manchester, NH 03109-4133 | 2005-11-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275960452 | Valerie Amador | Physical Therapy Assistant | 195 Sibley Terrace, Manchester, NH 03109 | 2013-10-02 |
| 1104894708 | Mahendra Singh Panesar | Pediatrics | Pediatric Health Associates, 275 Mammoth Road, Suite 1, Manchester, NH 03109 | 2006-03-09 |
| 1225004005 | Edward P. Dalton | Surgery | Elliot Breast Health Center, 275 Mammoth Road, Suite 1, Manchester, NH 03109 | 2006-02-23 |
| 1487644829 | Donald E. Salvatore | Pediatrics | 275 Mammoth Road, Suite 2, Manchester, NH 03109 | 2005-10-26 |
| 1831191659 | Elliot Physicians Network | Internal Medicine | 1070 Holt Avenue, Unit 1 Suite 2200, Manchester, NH 03109 | 2005-08-11 |
| 1457862195 | Julianne Jefferson | Nurse Practitioner | 271 Mammoth Rd, Manchester, NH 03109 | 2017-10-20 |
| 1154708964 | Jared Dunahay | Pediatrics | 275 Mammoth Rd Ste 2, Manchester, NH 03109 | 2015-04-30 |
| 1326474750 | Jason Michael Albrecht | Internal Medicine | 275 Mammoth Rd Ste 4, Manchester, NH 03109 | 2013-09-17 |
| 1316379266 | Johnson Orthodontics, Pllc | Dentist | 113 Mammoth Rd, Suite 1, Manchester, NH 03109 | 2013-08-02 |
| 1093941924 | Muhammad Muddasir Qureshi | Psychiatry & Neurology | 275 Mammoth Rd Ste 1, Manchester, NH 03109 | 2009-06-05 |
| Find all providers in zip 03109 | ||||
| Taxonomy Code | 2080N0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Neonatal-Perinatal Medicine |
| A pediatrician who is the principal care provider for sick newborn infants. Clinical expertise is used for direct patient care and for consulting with obstetrical colleagues to plan for the care of mothers who have high-risk pregnancies. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194785402 | Ernest F. Beale | Pediatrics | Neonatology Services - Elliot Hospital, One Elliot Way, Manchester, NH 03103 | 2006-03-23 |
| 1679919658 | Jessica G Clem | Pediatrics | 100 Mcgregor St, Manchester, NH 03102-3730 | 2013-05-16 |
| 1548495468 | Matthew William Ryzewski | Pediatrics | 1 Elliot Way, Nicu, Manchester, NH 03103-3502 | 2009-05-20 |
| 1720271224 | Amy D Mcbee | Pediatrics | 71 Haynes St, Neonatal Icu, Manchester, CT 06040-4131 | 2007-08-20 |
| 1770690372 | Malgorzata Bulanowski | Pediatrics | 1 Elliot Way, Neonatology Department, Manchester, NH 03103-3502 | 2006-08-23 |
| 1851353049 | Deborah A. Franzek | Pediatrics | 1 Elliot Way, Neonatology Services - Elliot Hospital, Manchester, NH 03103-3502 | 2006-04-04 |
| 1013976810 | Elliot Professional Services | Pediatrics | 1 Elliot Way, Neonatology Services, Manchester, NH 03103-3502 | 2006-03-21 |
| 1255314761 | Jorge Alba | Pediatrics | 71 Haynes St, Manchester, CT 06040-4131 | 2005-11-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891962916 | Neetu Singh | Pediatrics | 1 Medical Center Dr, Dhmc Department of Neonatology, Lebanon, NH 03756-1000 | 2008-05-08 |
| 1972611911 | Gautham K Suresh | Pediatrics | 1 Medical Center Dr, Dartmouth Hitchcock Medical Center, Lebanon, NH 03756-1000 | 2006-08-29 |
| 1871600569 | George Alexiy Little | Pediatrics | 1 Medical Center Dr, Lebanon, NH 03756-1000 | 2006-08-25 |
| 1497863948 | Robert A. Darnall Jr. | Pediatrics | 1 Medical Center Dr, Dhmc. Department of Pediatrics, Lebanon, NH 03756-1000 | 2006-08-25 |
| 1407963648 | William Horton Edwards | Pediatrics | 1 Medical Center Dr, Lebanon, NH 03756-1000 | 2006-08-24 |
| 1164489423 | Steven Alan Ringer | Pediatrics | 1 Medical Center Dr, Dhmc/neonatology, Lebanon, NH 03756-1000 | 2006-04-28 |
| 1891750717 | Juliette Carr Madan | Pediatrics | 1 Medical Center Dr, Dhmc Division of Neonatology, Lebanon, NH 03756-1000 | 2006-04-20 |
| 1750379582 | James E Gray | Pediatrics | 1 Medical Center Dr, Dartmouth Hitchcock - Neonatology, Lebanon, NH 03756-1000 | 2005-10-06 |
| City | MANCHESTER |
| Zip Code | 03109 |
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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.