Provider Demographics
NPI:1184900987
Name:GRANITE STATE ANESTHESIOLOGISTS, PA
Entity type:Organization
Organization Name:GRANITE STATE ANESTHESIOLOGISTS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CRNA
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BEGNAUD
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:603-943-5187
Mailing Address - Street 1:168 KINSLEY ST STE 4
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03060-3634
Mailing Address - Country:US
Mailing Address - Phone:603-882-1501
Mailing Address - Fax:
Practice Address - Street 1:168 KINSLEY ST STE 4
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060-3634
Practice Address - Country:US
Practice Address - Phone:603-882-1501
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-25
Last Update Date:2011-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH065283-23367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty