Provider Demographics
NPI:1457717316
Name:WINNIPESAUKEE EYE, PLLC
Entity Type:Organization
Organization Name:WINNIPESAUKEE EYE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER, WINNIPESAUKEE EYE, PLLC
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:MCMANUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-524-5770
Mailing Address - Street 1:950 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LACONIA
Mailing Address - State:NH
Mailing Address - Zip Code:03246-2628
Mailing Address - Country:US
Mailing Address - Phone:603-524-5770
Mailing Address - Fax:603-524-2424
Practice Address - Street 1:950 N MAIN ST
Practice Address - Street 2:
Practice Address - City:LACONIA
Practice Address - State:NH
Practice Address - Zip Code:03246-2628
Practice Address - Country:US
Practice Address - Phone:603-524-5770
Practice Address - Fax:603-524-2424
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-07
Last Update Date:2016-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH400261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH0005358213OtherAETNA
NHNH1158OtherHARVARD PILGRIM
NH80582287Medicaid
NHT25653Medicare UPIN