Provider Demographics
NPI:1295730109
Name:KNEISSL, URSULA S (MD)
Entity type:Individual
Prefix:DR
First Name:URSULA
Middle Name:S
Last Name:KNEISSL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:250 PLEASANT STREET
Mailing Address - Street 2:YEAPLE BUILDING
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-7539
Mailing Address - Country:US
Mailing Address - Phone:603-228-7200
Mailing Address - Fax:603-228-7307
Practice Address - Street 1:250 PLEASANT STREET
Practice Address - Street 2:YEAPLE BUILDING
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-7539
Practice Address - Country:US
Practice Address - Phone:603-228-7200
Practice Address - Fax:603-228-7307
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NH9736208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH222594672OtherGREATWEST HEALTHCARE
NHH005016OtherTRICARE
NH010626760NH01OtherANTHEM
NH222594672OtherHEALTHCARE VALUE MANAGE
NH222594672OtherPRIVATE HEALTH CARE
NH30009563Medicaid
NH370012514OtherRAILROAD MEDICARE
NHNH1563OtherHARVARD PILGRIM
NH3049839OtherAETNA
NH781323OtherMVP HEALTHCARE
NH12-40789OtherUNITED HEALTH CARE
NH2139312OtherCIGNA
NH30009563Medicaid
NHH06760Medicare UPIN