Provider Demographics
NPI:1851743876
Name:CONGRETE, SOONTHAREE (MD)
Entity Type:Individual
Prefix:
First Name:SOONTHAREE
Middle Name:
Last Name:CONGRETE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:246 PLEASANT ST
Mailing Address - Street 2:MEMORIAL BUILDING, WEST, GROUND FLOOR
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-2548
Mailing Address - Country:US
Mailing Address - Phone:603-224-9661
Mailing Address - Fax:603-227-7528
Practice Address - Street 1:246 PLEASANT ST.
Practice Address - Street 2:MEMORIAL BUILDING, WEST, GROUND FLOOR
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-2548
Practice Address - Country:US
Practice Address - Phone:603-224-9661
Practice Address - Fax:603-227-7528
Is Sole Proprietor?:No
Enumeration Date:2016-07-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NH22074207R00000X, 207RP1001X
MA268687207R00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program