Provider Demographics
NPI:1851277156
Name:PATRIOT ANESTHESIOLOGY PLLC
Entity type:Organization
Organization Name:PATRIOT ANESTHESIOLOGY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:GRAY
Authorized Official - Suffix:JR
Authorized Official - Credentials:DO
Authorized Official - Phone:603-484-9777
Mailing Address - Street 1:923 ELM ST # 102
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03101-2003
Mailing Address - Country:US
Mailing Address - Phone:603-484-9777
Mailing Address - Fax:
Practice Address - Street 1:52 RIDEOUT RD
Practice Address - Street 2:
Practice Address - City:HOLLIS
Practice Address - State:NH
Practice Address - Zip Code:03049-6110
Practice Address - Country:US
Practice Address - Phone:603-484-9777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-12
Last Update Date:2025-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service