Provider Demographics
NPI:1023191152
Name:PHYSICIAN'S DIAGNOSTIC SERVICES
Entity Type:Organization
Organization Name:PHYSICIAN'S DIAGNOSTIC SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MS
Authorized Official - First Name:SUE
Authorized Official - Middle Name:D
Authorized Official - Last Name:MAJEWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-622-3670
Mailing Address - Street 1:11 WASHINGTON PL
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03110-6747
Mailing Address - Country:US
Mailing Address - Phone:603-622-3670
Mailing Address - Fax:603-622-9134
Practice Address - Street 1:22 MAIN ST
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:NH
Practice Address - Zip Code:03079-5900
Practice Address - Country:US
Practice Address - Phone:603-898-0961
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH=========OtherTAX ID #