Provider Demographics
NPI:1063604809
Name:AMHERST PEDIATRICS, PLLC
Entity type:Organization
Organization Name:AMHERST PEDIATRICS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:A
Authorized Official - Last Name:CANFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:603-673-7577
Mailing Address - Street 1:31 OLD NASHUA RD
Mailing Address - Street 2:SUITE 14
Mailing Address - City:AMHERST
Mailing Address - State:NH
Mailing Address - Zip Code:03031-2829
Mailing Address - Country:US
Mailing Address - Phone:603-673-7577
Mailing Address - Fax:603-673-8788
Practice Address - Street 1:31 OLD NASHUA RD
Practice Address - Street 2:SUITE 14
Practice Address - City:AMHERST
Practice Address - State:NH
Practice Address - Zip Code:03031-2829
Practice Address - Country:US
Practice Address - Phone:603-673-7577
Practice Address - Fax:603-673-8788
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-15
Last Update Date:2007-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH8281208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30214649Medicaid