Provider Demographics
NPI:1952566507
Name:POMERANZ, JOANNE
Entity type:Individual
Prefix:
First Name:JOANNE
Middle Name:
Last Name:POMERANZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 DEER RUN RD
Mailing Address - Street 2:
Mailing Address - City:HOLLIS
Mailing Address - State:NH
Mailing Address - Zip Code:03049-6443
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9 DEER RUN RD
Practice Address - Street 2:
Practice Address - City:HOLLIS
Practice Address - State:NH
Practice Address - Zip Code:03049-6443
Practice Address - Country:US
Practice Address - Phone:603-465-7564
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-23
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH043591-23363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH301821Medicare Oscar/Certification