Provider Demographics
NPI:1154794261
Name:AP DERM NEW HAMPSHIRE PC
Entity type:Organization
Organization Name:AP DERM NEW HAMPSHIRE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:D
Authorized Official - Last Name:GOOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:978-371-7010
Mailing Address - Street 1:526 MAIN ST
Mailing Address - Street 2:SUITE 302
Mailing Address - City:ACTON
Mailing Address - State:MA
Mailing Address - Zip Code:01720-3301
Mailing Address - Country:US
Mailing Address - Phone:978-849-7500
Mailing Address - Fax:978-371-0522
Practice Address - Street 1:87 MCGREGOR ST STE 2100
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03102-3767
Practice Address - Country:US
Practice Address - Phone:603-626-7546
Practice Address - Fax:603-626-7548
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ADULT & PEDIATRIC DERMATOLOGY, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-11-11
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty