Provider Demographics
NPI:1962593277
Name:EMERALD HILL MEDICAL ASSOCIATES PLLC
Entity type:Organization
Organization Name:EMERALD HILL MEDICAL ASSOCIATES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:F
Authorized Official - Last Name:TARRY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:603-673-8388
Mailing Address - Street 1:PO BOX 2200
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NH
Mailing Address - Zip Code:03031-4200
Mailing Address - Country:US
Mailing Address - Phone:603-673-9411
Mailing Address - Fax:603-673-9899
Practice Address - Street 1:3 OVERLOOK DR
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NH
Practice Address - Zip Code:03031-2830
Practice Address - Country:US
Practice Address - Phone:603-672-8388
Practice Address - Fax:603-672-4280
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2007-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
694335OtherTUFTS HEALTH PLAN
67668OtherHEALTHSOURCE
NH30212383Medicaid