| Pine Psychiatry | |
|
2 S Park St Lebanon NH 03766-1384 | |
| (603) 865-7157 | |
| Not Available |
| Full Name | Pine Psychiatry |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 2 S Park St, Lebanon, New Hampshire |
| Authorized Official Name and Position | Timothy Bailey (OWNER) |
| Authorized Official Contact | 6038657157 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pine Psychiatry 2 S Park St Lebanon NH 03766-1384 Ph: (603) 865-7157 | Pine Psychiatry 2 S Park St Lebanon NH 03766-1384 Ph: (603) 865-7157 |
| NPI Number | 1922716596 |
|---|---|
| Provider Enumeration Date | 11/11/2022 |
| Last Update Date | 09/13/2023 |
| Certification Date | 09/13/2023 |
| Medicare PECOS PAC ID | 4284089046 |
|---|---|
| Medicare Enrollment ID | O20231013001468 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922716596 | NPI | - | NPPES |
| Provider Name | Timothy A Bailey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063013423 PECOS PAC ID: 7517360142 Enrollment ID: I20210720003242 |
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