Provider Demographics
NPI:1922198951
Name:MANCHESTER OBSTETRICAL ASSOCIATES, PA
Entity Type:Organization
Organization Name:MANCHESTER OBSTETRICAL ASSOCIATES, PA
Other - Org Name:REPRODUCTIVE SERVICES OF MANCHESTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HEIDI
Authorized Official - Middle Name:L
Authorized Official - Last Name:MEINZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:603-622-3162
Mailing Address - Street 1:150 TARRYTOWN RD
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03103-2713
Mailing Address - Country:US
Mailing Address - Phone:603-622-3162
Mailing Address - Fax:603-622-8677
Practice Address - Street 1:150 TARRYTOWN RD
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03103-2713
Practice Address - Country:US
Practice Address - Phone:603-622-3162
Practice Address - Fax:603-622-8677
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-13
Last Update Date:2010-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH11180174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH81163728Medicaid
NHNH3728Medicare ID - Type UnspecifiedMEDICARE GROUP ID