Provider Demographics
NPI:1629775150
Name:CUSHMAN, ELISE
Entity Type:Individual
Prefix:
First Name:ELISE
Middle Name:
Last Name:CUSHMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 LYFORD HILL RD UNIT 4
Mailing Address - Street 2:
Mailing Address - City:PITTSFIELD
Mailing Address - State:NH
Mailing Address - Zip Code:03263-3232
Mailing Address - Country:US
Mailing Address - Phone:603-359-1951
Mailing Address - Fax:
Practice Address - Street 1:54 HARVEST LANE
Practice Address - Street 2:
Practice Address - City:CHICHESTER
Practice Address - State:NH
Practice Address - Zip Code:03258
Practice Address - Country:US
Practice Address - Phone:603-496-1134
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-15
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide