1447232343 NPI number — SUSAN ROSE GAIRE MD FACOG

Table of content: MARY HEATHER NETROW FNP-BC (NPI 1386189280)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447232343 NPI number — SUSAN ROSE GAIRE MD FACOG

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GAIRE
Provider First Name:
SUSAN
Provider Middle Name:
ROSE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD FACOG
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1447232343
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/14/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
21 WHITEHALL RD
Provider Second Line Business Mailing Address:
SUITE 303
Provider Business Mailing Address City Name:
ROCHESTER
Provider Business Mailing Address State Name:
NH
Provider Business Mailing Address Postal Code:
03867
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
603-335-6988
Provider Business Mailing Address Fax Number:
603-335-6802

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
235 ROCHESTER HILL RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ROCHESTER
Provider Business Practice Location Address State Name:
NH
Provider Business Practice Location Address Postal Code:
03867-1775
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
603-335-6988
Provider Business Practice Location Address Fax Number:
603-335-6802
Provider Enumeration Date:
11/16/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207V00000X , with the licence number:  11909 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 01Y003924NH02 . This is a "ANTHEM" identifier . This identifiers is of the category "OTHER".
  • Identifier: AA53456 . This is a "HARVARD PILGRIM HLTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1192458 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 389932 . This is a "MVP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 30205866 , issued by the state of ( NH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 306230099 , issued by the state of ( ME ) . This identifiers is of the category "MEDICAID".
  • Identifier: 6207751 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".




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