Provider Demographics
NPI:1427404177
Name:TSEYTLIN, ELIZABETH G (DO)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:G
Last Name:TSEYTLIN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:J
Other - Last Name:GOLD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:445 CYPRESS ST STE 5
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03103-3600
Mailing Address - Country:US
Mailing Address - Phone:603-663-8200
Mailing Address - Fax:
Practice Address - Street 1:445 CYPRESS ST STE 5
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03103-3600
Practice Address - Country:US
Practice Address - Phone:603-663-8200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-12
Last Update Date:2022-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH20764207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3124090Medicaid