| Integrated Wound Care New Hampshire Pllc | |
|
928 South St Portsmouth NH 03801-5421 | |
| (718) 963-3495 | |
| Not Available |
| Full Name | Integrated Wound Care New Hampshire Pllc |
|---|---|
| Speciality | General Practice |
| Location | 928 South St, Portsmouth, New Hampshire |
| Authorized Official Name and Position | Diane Lusas (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 7189633495 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Integrated Wound Care New Hampshire Pllc 492c Cedar Ln Ste 514 Teaneck NJ 07666-1713 Ph: () - | Integrated Wound Care New Hampshire Pllc 928 South St Portsmouth NH 03801-5421 Ph: (718) 963-3495 |
| NPI Number | 1033983127 |
|---|---|
| Provider Enumeration Date | 11/09/2023 |
| Last Update Date | 11/09/2023 |
| Medicare PECOS PAC ID | 5799135166 |
|---|---|
| Medicare Enrollment ID | O20231227001858 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033983127 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Carlo Kariuki |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932746013 PECOS PAC ID: 3375921810 Enrollment ID: I20240109001107 |
| Provider Name | Diane Lusas |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1730475658 PECOS PAC ID: 9032430640 Enrollment ID: I20240109002138 |
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