Provider Demographics
NPI:1588855258
Name:THE ALPINE CLINIC, PLLC
Entity Type:Organization
Organization Name:THE ALPINE CLINIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:L
Authorized Official - Last Name:CHEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:603-823-8600
Mailing Address - Street 1:1095 PROFILE ROAD
Mailing Address - Street 2:
Mailing Address - City:FRANCONIA
Mailing Address - State:NH
Mailing Address - Zip Code:03580
Mailing Address - Country:US
Mailing Address - Phone:603-823-8600
Mailing Address - Fax:603-823-8688
Practice Address - Street 1:1095 PROFILE ROAD
Practice Address - Street 2:
Practice Address - City:FRANCONIA
Practice Address - State:NH
Practice Address - Zip Code:03580
Practice Address - Country:US
Practice Address - Phone:603-823-8600
Practice Address - Fax:603-823-8688
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-07
Last Update Date:2019-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH12418207X00000X
332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30216095Medicaid
NH0002417Medicare PIN
NH6058360001Medicare NSC