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835 Hanover St Ste 305 Manchester NH 03104-5401 | |
| (603) 784-9012 | |
| (603) 784-9012 |
| Full Name | |
|---|---|
| Speciality | Clinical Nurse Specialist |
| Location | 835 Hanover St Ste 305, Manchester, New Hampshire |
| Authorized Official Name and Position | Susan Sherr (BILLING ADMINISTRATOR) |
| Authorized Official Contact | 6034724690 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
170 Commerce Way Portsmouth NH 03801-3226 Ph: () - | 835 Hanover St Ste 305 Manchester NH 03104-5401 Ph: (603) 784-9012 |
| NPI Number | 1063127645 |
|---|---|
| Provider Enumeration Date | 01/18/2023 |
| Last Update Date | 01/28/2025 |
| Certification Date | 01/28/2025 |
| Medicare PECOS PAC ID | 8729528468 |
|---|---|
| Medicare Enrollment ID | O20240910000509 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063127645 | NPI | - | NPPES |
| Provider Name | Carmella M Dow |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548809130 PECOS PAC ID: 3274946959 Enrollment ID: I20210120000604 |
| Provider Name | Ry Billadeau |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073145199 PECOS PAC ID: 6406261114 Enrollment ID: I20210210001706 |
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