Provider Demographics
NPI:1417146036
Name:SABINE H MANOLI MD, PLLC
Entity Type:Organization
Organization Name:SABINE H MANOLI MD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:JOY
Authorized Official - Middle Name:A
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-598-0220
Mailing Address - Street 1:168 KINSLEY ST
Mailing Address - Street 2:SUITE LL
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03060-3634
Mailing Address - Country:US
Mailing Address - Phone:603-598-0455
Mailing Address - Fax:603-598-0456
Practice Address - Street 1:168 KINSLEY ST
Practice Address - Street 2:SUITE LL
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060-3634
Practice Address - Country:US
Practice Address - Phone:603-598-0455
Practice Address - Fax:603-598-0456
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-19
Last Update Date:2009-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
RE8403OtherMEDICARE GROUP NUMBER
NH30205482Medicaid
NH30205482Medicaid