Mascoma Street Inpatient Services LLC

NPI #1780137802 in Lebanon, New Hampshire

Provider Information

NPI Number: 1780137802
Entity Type: Organization
Organization Name: Mascoma Street Inpatient Services LLC
Primary Specialty: Hospitalist
Enumeration Date: Jul 25, 2016
Last Updated: Sep 10, 2019

Practice Location

Address: 10 ALICE PECK DAY DR
City: Lebanon
State: New Hampshire
ZIP Code: 03766-2900
Phone: (469) 401-2386

Authorized Official

Name: RUSSELL HARRIS, MD
Title: PRESIDENT
Phone: (954) 838-2371

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Hospitalist	208M00000X	Primary

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