MERRIMACK VALLEY PET PC (NPI# 1922055094) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922055094 |
| Entity Type | Organization |
| Organization Name | MERRIMACK VALLEY PET PC |
| Other Organization Name | NEW ENGLAND PET IMAGING SYSTEM |
| Practice Address |
185 Queen City Ave Manchester NH 03101-7121 |
| Mailing Address |
354 Merrimack St Lawrence MA 01843-1754 |
| Practice Telephone | 6036632370 |
| Practice Fax Number | 6036632379 |
| Mailing Telephone | 9786878187 |
| Mailing Fax Number | 9786878185 |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2011-12-30 |
| Authorized Official Name | MARK R TAYLOR (CEO) |
| Authorized Official Telephone | 9786872321 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0208X |
Clinic/Center Specialization: Radiology, Mobile |
446R | NH | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BLUE CROSS OF NH | 15Y002275MA02 | 01 | |
| NH | 30813476 | 05 | |
| HARVARD PILGRIM | 626241 | 01 | |
| TUFTS | 685730 | 01 | |
| AETNA | 3184391 | 01 |
| Other Name | Type Code |
|---|---|
| New England PET Imaging System | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407802416 | Merrimack Valley Pet PC | Clinic/Center | 70 East St, Methuen, MA 01844-4597 | 2006-05-25 |
| Street Address |
185 QUEEN CITY AVE |
| 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 | 261QR0208X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Radiology, Mobile |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740563428 | Insight-premier Health LLC | Clinic/Center | 27 Bowdoin Street, Manchester, ME 04351 | 2011-09-20 |
| 1952447666 | Christopher P Bristol | Clinic/Center | 83 Hanover St, Suite 1b, Manchester, NH 03101-2216 | 2007-01-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508497413 | New England Molecular Imaging LLC | Clinic/Center | 6 Tsienneto Rd Ste 100ll, Derry, NH 03038-1584 | 2020-01-29 |
| 1255420469 | Merrimack Valley Sonographic Services,inc. | Clinic/Center | 141 Warner Hill Rd, Derry, NH 03038-4716 | 2006-10-12 |
| 1245853852 | Pdi Health Nh LLC | Clinic/Center | 1 Tara Blvd, Nashua, NH 03062-2809 | 2020-05-19 |
| 1952671943 | John W Edelblute | Clinic/Center | 141 Warner Hill Rd, Derry, NH 03038-4716 | 2012-01-06 |
| 1770676686 | New England Mobile X-ray | Clinic/Center | 1 Merrill Industrial Dr, Suite 19, Hampton, NH 03842-1981 | 2006-10-02 |
| City | MANCHESTER |
| Zip Code | 03101 |
Please comment or provide details below to improve the information on MERRIMACK VALLEY PET PC.
| 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.