Provider Demographics
NPI:1275508988
Name:CHOPRA, MANISH (MD)
Entity Type:Individual
Prefix:
First Name:MANISH
Middle Name:
Last Name:CHOPRA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:SENIOR HEALTH PRIMARY CARE
Mailing Address - Street 2:138 WEBSTER STREET
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03104
Mailing Address - Country:US
Mailing Address - Phone:603-663-7030
Mailing Address - Fax:603-663-7039
Practice Address - Street 1:SENIOR HEALTH PRIMARY CARE
Practice Address - Street 2:138 WEBSTER STREET
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03104
Practice Address - Country:US
Practice Address - Phone:603-663-7030
Practice Address - Fax:603-663-7039
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH12646207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH01YP08439NH01OtherANTHEM BCBS PIN
NHAA37808OtherHARVARD PILGRIM PIN
NH3953965OtherAETNA PIN
NH30205206Medicaid
NH31051YOtherANTHEM REFERRING RAN
NH3960616OtherCIGNA PIN
NH466562OtherTUFTS PIN
NH01YP08439NH01OtherANTHEM BCBS PIN
NH466562OtherTUFTS PIN