Provider Demographics
NPI:1790880516
Name:DERRY NEUROLOGICAL ASSOCIATES, PC
Entity Type:Organization
Organization Name:DERRY NEUROLOGICAL ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:D
Authorized Official - Last Name:RIND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:603-434-3525
Mailing Address - Street 1:44 BIRCH ST STE 305
Mailing Address - Street 2:
Mailing Address - City:DERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03038-2752
Mailing Address - Country:US
Mailing Address - Phone:603-434-3525
Mailing Address - Fax:603-434-2877
Practice Address - Street 1:44 BIRCH ST STE 305
Practice Address - Street 2:
Practice Address - City:DERRY
Practice Address - State:NH
Practice Address - Zip Code:03038-2752
Practice Address - Country:US
Practice Address - Phone:603-434-3525
Practice Address - Fax:603-434-2877
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-14
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2084N0400X, 2084N0400X
NH8276 JEFFREY RIND2084N0400X
NH11639 JOHN RESCIGNO2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30212511Medicaid
NH30212511Medicaid
NHJERE6774Medicare ID - Type Unspecified