Provider Demographics
NPI:1134745078
Name:O'GRADY, CLARE ELIZABETH (DO)
Entity type:Individual
Prefix:
First Name:CLARE
Middle Name:ELIZABETH
Last Name:O'GRADY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:89 COLES LEDGE RD
Mailing Address - Street 2:
Mailing Address - City:BARNSTEAD
Mailing Address - State:NH
Mailing Address - Zip Code:03218-3773
Mailing Address - Country:US
Mailing Address - Phone:603-391-8126
Mailing Address - Fax:
Practice Address - Street 1:250 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-2598
Practice Address - Country:US
Practice Address - Phone:603-225-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-16
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHRT-3643207Q00000X
VT032.0134200207QH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine