Provider Demographics
NPI:1801031661
Name:TRAVEL HEALTH OF NEW HAMPSHIRE PLLC
Entity type:Organization
Organization Name:TRAVEL HEALTH OF NEW HAMPSHIRE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:E
Authorized Official - Last Name:DIRUBBO
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:603-524-1103
Mailing Address - Street 1:501 UNION AVE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:LACONIA
Mailing Address - State:NH
Mailing Address - Zip Code:03246-2867
Mailing Address - Country:US
Mailing Address - Phone:603-524-1103
Mailing Address - Fax:
Practice Address - Street 1:501 UNION AVE
Practice Address - Street 2:SUITE 3
Practice Address - City:LACONIA
Practice Address - State:NH
Practice Address - Zip Code:03246-2867
Practice Address - Country:US
Practice Address - Phone:603-524-1103
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-09
Last Update Date:2008-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0221892303261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service