Provider Demographics
NPI:1326278748
Name:EDELWEISS FAMILY CARE & TELEHEALTH,LLC
Entity Type:Organization
Organization Name:EDELWEISS FAMILY CARE & TELEHEALTH,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:MRS
Authorized Official - First Name:EVA
Authorized Official - Middle Name:M
Authorized Official - Last Name:ENZINGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:603-740-4550
Mailing Address - Street 1:1 ROUTE 236
Mailing Address - Street 2:SUITE 3
Mailing Address - City:KITTERY
Mailing Address - State:ME
Mailing Address - Zip Code:03904-5528
Mailing Address - Country:US
Mailing Address - Phone:603-740-4550
Mailing Address - Fax:603-740-4551
Practice Address - Street 1:750 CENTRAL AVE
Practice Address - Street 2:SUITE L
Practice Address - City:DOVER
Practice Address - State:NH
Practice Address - Zip Code:03820-3434
Practice Address - Country:US
Practice Address - Phone:603-740-4550
Practice Address - Fax:603-740-4551
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-20
Last Update Date:2009-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH11732207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty