Provider Demographics
NPI:1386613479
Name:DUFFY, EDWARD L (MD)
Entity type:Individual
Prefix:
First Name:EDWARD
Middle Name:L
Last Name:DUFFY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 160
Mailing Address - Street 2:PATIENT FINANCIAL SERVICES
Mailing Address - City:LITTLETON
Mailing Address - State:NH
Mailing Address - Zip Code:03561
Mailing Address - Country:US
Mailing Address - Phone:603-259-7627
Mailing Address - Fax:603-259-7561
Practice Address - Street 1:600 ST. JOHNSBURY RD.
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:NH
Practice Address - Zip Code:03561
Practice Address - Country:US
Practice Address - Phone:603-444-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2014-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH8293207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH0104700Y0NH01OtherBLUE CROSS BLUE SHIELD
NH80300008Medicaid
NH43778OtherCIGNA HEALTHCARE
VT39803OtherBLUE CROSS BLUE SHIELD
VT1003464Medicaid
NHE29951Medicare UPIN
VT1003464Medicaid