Provider Demographics
NPI:1588867667
Name:HANOVER CONTINUITY CLINIC, PLLC
Entity type:Organization
Organization Name:HANOVER CONTINUITY CLINIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:JULES
Authorized Official - Last Name:SCHWARZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:603-643-3320
Mailing Address - Street 1:45 LYME RD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:HANOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03755-1219
Mailing Address - Country:US
Mailing Address - Phone:603-643-3320
Mailing Address - Fax:603-643-3301
Practice Address - Street 1:45 LYME RD
Practice Address - Street 2:SUITE 104
Practice Address - City:HANOVER
Practice Address - State:NH
Practice Address - Zip Code:03755-1220
Practice Address - Country:US
Practice Address - Phone:603-643-3320
Practice Address - Fax:603-643-3301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-07
Last Update Date:2015-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH10169261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH10169OtherMEDICAL LICENCE NUMBER
NH12968OtherLICENSE
NH0000467OtherMEDICARE PTAN
VT420011112OtherMEDICAL LICENCE NUMBER
NH10169OtherMEDICAL LICENCE NUMBER