| Ibis Health Services-new Hampshire Pllc | |
|
24 Heathrow Ct Nashua NH 03063-1524 | |
| (603) 664-4800 | |
| (207) 401-2727 |
| Full Name | Ibis Health Services-new Hampshire Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 24 Heathrow Ct, Nashua, New Hampshire |
| Authorized Official Name and Position | Gary M Janko (ADMINISTRATOR) |
| Authorized Official Contact | 6039214947 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ibis Health Services-new Hampshire Pllc 215 Ayer Rd Unit 797 Harvard MA 01451-5033 Ph: (603) 664-4800 | Ibis Health Services-new Hampshire Pllc 24 Heathrow Ct Nashua NH 03063-1524 Ph: (603) 664-4800 |
| NPI Number | 1871087619 |
|---|---|
| Provider Enumeration Date | 06/15/2018 |
| Last Update Date | 08/21/2023 |
| Medicare PECOS PAC ID | 4486904422 |
|---|---|
| Medicare Enrollment ID | O20180912001872 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871087619 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| Provider Name | Caille S Roy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033629068 PECOS PAC ID: 4880956077 Enrollment ID: I20181120000450 |
| Provider Name | Carissa Kelly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821307646 PECOS PAC ID: 2264627132 Enrollment ID: I20220120002421 |
| Provider Name | Carol Ann Buller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811940059 PECOS PAC ID: 6901831221 Enrollment ID: I20240729000194 |
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