Provider Demographics
NPI:1437339314
Name:CHESHIRE MEDICAL ASSOCIATES
Entity Type:Organization
Organization Name:CHESHIRE MEDICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:LESTER
Authorized Official - Last Name:STERN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:603-352-5000
Mailing Address - Street 1:85 EMERALD ST
Mailing Address - Street 2:SUITE 115
Mailing Address - City:KEENE
Mailing Address - State:NH
Mailing Address - Zip Code:03431-3627
Mailing Address - Country:US
Mailing Address - Phone:603-352-5000
Mailing Address - Fax:603-358-3758
Practice Address - Street 1:85 EMERALD ST
Practice Address - Street 2:SUITE 115
Practice Address - City:KEENE
Practice Address - State:NH
Practice Address - Zip Code:03431-3627
Practice Address - Country:US
Practice Address - Phone:603-352-5000
Practice Address - Fax:603-358-3758
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-08
Last Update Date:2007-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHNH6383261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHC65776Medicare UPIN