Provider Demographics
NPI:1700079118
Name:GEMBA, ELIZABETH MARIE (PA-C)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:MARIE
Last Name:GEMBA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MRS
Other - First Name:ELIZABETH
Other - Middle Name:MARIE
Other - Last Name:CURRAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2 MANOR PKWY STE 5
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:NH
Mailing Address - Zip Code:03079-4871
Mailing Address - Country:US
Mailing Address - Phone:603-898-5082
Mailing Address - Fax:603-890-5453
Practice Address - Street 1:2 MANOR PKWY STE 5
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:NH
Practice Address - Zip Code:03079-4871
Practice Address - Country:US
Practice Address - Phone:603-898-5082
Practice Address - Fax:603-890-5453
Is Sole Proprietor?:No
Enumeration Date:2007-08-20
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0644363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3101977Medicaid