Provider Demographics
NPI:1437220076
Name:PROCARE PHYSICAL THERAPY AND HAND CENTER
Entity Type:Organization
Organization Name:PROCARE PHYSICAL THERAPY AND HAND CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:MAYO
Authorized Official - Middle Name:
Authorized Official - Last Name:NOERDLINGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:603-431-1121
Mailing Address - Street 1:150 US HIGHWAY 1 BYP
Mailing Address - Street 2:SUITE 1
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-5332
Mailing Address - Country:US
Mailing Address - Phone:603-431-1121
Mailing Address - Fax:
Practice Address - Street 1:150 US HIGHWAY 1 BYP
Practice Address - Street 2:SUITE 1
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-5332
Practice Address - Country:US
Practice Address - Phone:603-431-1121
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-13
Last Update Date:2008-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHandGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
9984995OtherCIGNA GROUP #
AA79032OtherHARVARD PILGRIM GROUP #
9984995OtherCIGNA GROUP #
NH5941140001Medicare NSC