Provider Demographics
NPI:1609971001
Name:ADAM P. BECK MD PC
Entity Type:Organization
Organization Name:ADAM P. BECK MD PC
Other - Org Name:NEW ENGLAND EYE AND FACIAL SPECIALISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TARIALY
Authorized Official - Middle Name:I
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-682-4040
Mailing Address - Street 1:75 GILCREAST RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:LONDONDERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03053-3564
Mailing Address - Country:US
Mailing Address - Phone:603-421-0095
Mailing Address - Fax:603-421-0093
Practice Address - Street 1:75 GILCREAST RD
Practice Address - Street 2:SUITE 210
Practice Address - City:LONDONDERRY
Practice Address - State:NH
Practice Address - Zip Code:03053-3564
Practice Address - Country:US
Practice Address - Phone:603-421-0095
Practice Address - Fax:603-421-0093
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-13
Last Update Date:2015-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH12594174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHRE8860Medicare PIN