Provider Demographics
NPI:1396058848
Name:GAMBALE, SUZANNE R
Entity type:Individual
Prefix:DR
First Name:SUZANNE
Middle Name:R
Last Name:GAMBALE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 KEARNS DR
Mailing Address - Street 2:
Mailing Address - City:MERRIMACK
Mailing Address - State:NH
Mailing Address - Zip Code:03054-3112
Mailing Address - Country:US
Mailing Address - Phone:603-568-5180
Mailing Address - Fax:
Practice Address - Street 1:19 WILTON RD
Practice Address - Street 2:
Practice Address - City:PETERBOROUGH
Practice Address - State:NH
Practice Address - Zip Code:03458-1799
Practice Address - Country:US
Practice Address - Phone:603-924-3632
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-26
Last Update Date:2010-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH3700183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist