Provider Demographics
NPI:1972559433
Name:CLARDY, ELIZABETH (MD)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:
Last Name:CLARDY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-7559
Mailing Address - Country:US
Mailing Address - Phone:603-228-7200
Mailing Address - Fax:603-227-7562
Practice Address - Street 1:250 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-7559
Practice Address - Country:US
Practice Address - Phone:603-228-7200
Practice Address - Fax:603-227-7562
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2021-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH9186207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHC83236Medicare UPIN