NPIMap

Organization Active NPI

Elliot Professional Services

Doing business as Elliot Dermatology

  • Dermatology Physician
  • Manchester, NH
National Provider Identifier
1912255118
Registry record updated Aug 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
ELLIOT PROFESSIONAL SERVICES
Doing business as
Elliot Dermatology
Practice address
185 Queen City Ave
Elliot Dermatology
Manchester, NH 03101-7121
Phone
(603) 314-6930
Fax
(603) 314-6939
NPI assigned
Aug 17, 2012
Last updated
Aug 17, 2012By the provider in NPPES
Organization subpart
Yes
Parent organization
ELLIOT PROFESSIONAL SERVICESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 17, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Richard P Herman
Title
Director
Phone
(603) 663-4904

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X NU Primary

Addresses

Primary practice location

185 Queen City Ave
Elliot Dermatology
Manchester, NH 03101-7121

Mailing address

185 Queen City Ave
Elliot Dermatology
Manchester, NH 03101-7121
Phone (603) 314-6930

Other names 1

  • ELLIOT DERMATOLOGY Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Elliot Professional Ser35 organizations share this tax ID, including this one
Part of
Elliot Professional Ser

Other organizations with this tax ID 34

Organizations that report the same tax identification number in the National Provider Directory.

View all 34

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1345161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1345161600000",
    "number": "1912255118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "185 QUEEN CITY AVE",
            "address_2": "ELLIOT DERMATOLOGY",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031017121",
            "telephone_number": "603-314-6930",
            "fax_number": "603-314-6939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 QUEEN CITY AVE",
            "address_2": "ELLIOT DERMATOLOGY",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031017121",
            "telephone_number": "603-314-6930",
            "fax_number": "603-314-6939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELLIOT PROFESSIONAL SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ELLIOT PROFESSIONAL SERVICES",
        "enumeration_date": "2012-08-17",
        "last_updated": "2012-08-17",
        "status": "A",
        "authorized_official_last_name": "HERMAN",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "603-663-4904"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ELLIOT DERMATOLOGY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Manchester, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.