Provider Demographics
NPI:1457310765
Name:ASSOCIATED RADIOLOGIST,PA
Entity Type:Organization
Organization Name:ASSOCIATED RADIOLOGIST,PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:A
Authorized Official - Last Name:BEAULIEU
Authorized Official - Suffix:
Authorized Official - Credentials:RTR,CT,RCC
Authorized Official - Phone:603-883-4636
Mailing Address - Street 1:PO BOX 291
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:NH
Mailing Address - Zip Code:03051-0291
Mailing Address - Country:US
Mailing Address - Phone:603-883-4636
Mailing Address - Fax:603-883-6854
Practice Address - Street 1:6 TSIENNETO RD
Practice Address - Street 2:DERRY IMAGING
Practice Address - City:DERRY
Practice Address - State:NH
Practice Address - Zip Code:03038-0291
Practice Address - Country:US
Practice Address - Phone:603-883-4636
Practice Address - Fax:603-883-6854
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-23
Last Update Date:2022-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHNH3590OtherMEDICARE PTAN
NHNH3590Medicare ID - Type Unspecified