ELLIOT PROFESSIONAL SERVICES (NPI# 1912255118) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912255118 |
| Entity Type | Organization |
| Organization Name | ELLIOT PROFESSIONAL SERVICES |
| Other Organization Name | ELLIOT DERMATOLOGY |
| Practice Address |
185 Queen City Ave Elliot Dermatology Manchester NH 03101-7121 |
| Practice Telephone | 6033146930 |
| Practice Fax Number | 6033146939 |
| Mailing Telephone | 6033146930 |
| Mailing Fax Number | 6033146939 |
| Enumeration Date | 2012-08-17 |
| Last Update Date | 2012-08-17 |
| Authorized Official Name | RICHARD P HERMAN (DIRECTOR) |
| 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 | 207N00000X | Dermatology | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| ELLIOT DERMATOLOGY | Doing Business As Name - 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 |
| 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 |
| 1124397187 | Elliot Professional Services | Pediatrics | 275 Mammoth Rd Ste 1, Elliot Developmental and Behavioral Pediatrics, Manchester, NH 03109-4133 | 2011-12-21 |
| Street Address |
185 QUEEN CITY AVE ELLIOT DERMATOLOGY |
| City | MANCHESTER |
| State | NH |
| Zip Code | 03101-7121 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992700702 | Stephen M. Wiener | Internal Medicine | 185 Queen City Ave, Manchester, NH 03101-7121 | 2005-06-17 |
| 1174140966 | Patrick John Hammer | Physical Therapist | 185 Queen City Ave, Manchester, NH 03101-7121 | 2020-06-29 |
| 1144870601 | Leah Hixon | Nurse Practitioner | 185 Queen City Ave, Manchester, NH 03101-7121 | 2019-09-17 |
| 1821565813 | Kathryn Swegles | Physician Assistant | 185 Queen City Ave, Manchester, NH 03101-7121 | 2018-10-27 |
| 1679086839 | Shannon Kelly Ward | Nurse Practitioner | 185 Queen City Ave, Manchester, NH 03101-7121 | 2017-11-09 |
| 1679085302 | Marialaina Abbene Tomolonis | Physician Assistant | 185 Queen City Ave, Manchester, NH 03101-7121 | 2017-11-03 |
| 1225547268 | Susan Marie Dionne | Registered Nurse | 185 Queen City Ave, Manchester, NH 03101-7121 | 2017-09-21 |
| 1649713827 | Emily M Miller | Physician Assistant | 185 Queen City Ave, Manchester, NH 03101-7121 | 2016-11-21 |
| 1598211948 | Jamie M. Gumb | Physician Assistant | 185 Queen City Ave, Manchester, NH 03101 | 2016-08-26 |
| 1447635263 | Laura Kathryn Radlinski | Physician Assistant | 185 Queen City Ave, Manchester, NH 03101 | 2015-07-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003320425 | Miranda Sherburne | Occupational Therapist | 470 Pine Street, Manchester, NH 03101 | 2017-11-21 |
| 1396266938 | Juliette W Daniels | Social Worker | 464 Chestnut Street, Child and Family Services, Manchester, NH 03101 | 2017-07-05 |
| 1851820450 | Samantha Ysabelle Kattiria | Specialist/Technologist | 39 Kosciuszko Street, Apt 4, Manchester, NH 03101 | 2017-06-07 |
| 1598121188 | Angelique Alicia Fortin | Counselor | 77 Pearl St., Manchester, NH 03101 | 2016-01-12 |
| 1578946786 | Reta Goldman | Counselor | 25 Lowell St Ste 208, Manchester, NH 03101 | 2015-07-07 |
| 1306239207 | Myra Jean Nikitas | Dental Hygienist | 97 West Merrimack Street, Manchester, NH 03101 | 2015-03-17 |
| 1902234586 | Judith Patrick Ronshagen | Pharmacist | 175 Queen City Avenue, Ste 1, Manchester, NH 03101 | 2013-10-17 |
| 1942566336 | Elizabeth Zavagnin | Specialist | 2 Wall St Ste 200, Manchester, NH 03101 | 2012-04-10 |
| 1538463088 | William Gerald Mccormick | Pharmacist | 175 Queen City Ave, Manchester, NH 03101 | 2010-12-27 |
| 1215241799 | Melissa Ann Dinoto | Counselor | 20 Market St., Manchester, NH 03101 | 2010-07-27 |
| Find all providers in zip 03101 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972524437 | John Andrew Watson | Dermatology | 87 Mcgregor St Ste 2100, Manchester, NH 03102-3767 | 2006-07-21 |
| 1154794261 | Ap Derm New Hampshire PC | Dermatology | 87 Mcgregor St, Suite 2100, Manchester, NH 03102-3765 | 2015-11-11 |
| 1750729307 | Jillian F Rork | Dermatology | 100 Hitchcock Way, Dermatology, Manchester, NH 03104 | 2013-06-05 |
| 1508153313 | Sarit J Itenberg | Dermatology | 185 Queen City Ave, Elliot Dermatology, Manchester, NH 03101-7121 | 2011-06-30 |
| 1467688903 | Herbert Cheuhui Chiang | Dermatology | 185 Queen City Ave, Manchester, NH 03101-7121 | 2009-06-10 |
| 1912115676 | Fw Danby, Md & Lj Margesson, Md, Pa | Dermatology | 721 Chestnut St, Manchester, NH 03104-3002 | 2007-05-18 |
| 1881794493 | Hamad Alabdulrazzaq | Dermatology | 87 Mcgregor St, Suite 2100, Manchester, NH 03102-3765 | 2006-09-24 |
| 1891731022 | Mark Jon Quitadamo | Dermatology | 100 Hitchcock Way, Manchester, NH 03104-4125 | 2006-06-22 |
| 1720014954 | Daniel B Stewart | Dermatology | 100 Hitchcock Way, Manchester, NH 03104-4125 | 2006-06-22 |
| 1336180090 | Robert John Willer | Dermatology | 100 Hitchcock Way, Manchester, NH 03104-4125 | 2006-06-10 |
| Find all providers in MANCHESTER | ||||
| City | MANCHESTER |
| Zip Code | 03101 |
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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.