Provider Demographics
NPI:1205083789
Name:MEDICAL AMBULATORY DOCTORS OF NEW HAMPSHIRE PLLC
Entity type:Organization
Organization Name:MEDICAL AMBULATORY DOCTORS OF NEW HAMPSHIRE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MAGUED
Authorized Official - Middle Name:Y
Authorized Official - Last Name:RIZKALLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:603-918-6456
Mailing Address - Street 1:288 LAFAYETTE RD BLDG A
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-5431
Mailing Address - Country:US
Mailing Address - Phone:603-436-5533
Mailing Address - Fax:603-964-2332
Practice Address - Street 1:288 LAFAYETTE RD BLDG A
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-5431
Practice Address - Country:US
Practice Address - Phone:603-436-5533
Practice Address - Fax:603-964-2332
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-26
Last Update Date:2008-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QM2500X
NH10104261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty