Berube, Randy G

Berube, Randy G is an individual health care provider with primary practice located at 700 Lake Ave , Manchester NH 03103-2734. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Berube, Randy G can be contacted via phone (603) 625-1864.

Contact Information

Primary practice address
700 Lake Ave Manchester NH 03103-2734
Phone: (603) 625-1864
Fax: (603) 668-7181
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 1772 New Hampshire

Profile Details

NPI number 1306843024
LBN Legal business name Berube, Randy G
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 7th, 2005
Last updated Jul 11th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1306843024 NPPES
New Hampshire MEDICAID 30392139

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