Provider Demographics
NPI:1871087619
Name:IBIS HEALTH SERVICES-NEW HAMPSHIRE PLLC
Entity type:Organization
Organization Name:IBIS HEALTH SERVICES-NEW HAMPSHIRE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:M
Authorized Official - Last Name:JANKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-921-4947
Mailing Address - Street 1:215 AYER RD UNIT 797
Mailing Address - Street 2:
Mailing Address - City:HARVARD
Mailing Address - State:MA
Mailing Address - Zip Code:01451-5033
Mailing Address - Country:US
Mailing Address - Phone:603-664-4800
Mailing Address - Fax:207-401-2727
Practice Address - Street 1:24 HEATHROW CT
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03063-1524
Practice Address - Country:US
Practice Address - Phone:603-664-4800
Practice Address - Fax:207-401-2727
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-15
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty