Basic Information
| Provider Information | |||||||||
| NPI: | 1669940045 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PALENTCHAR | ||||||||
| FirstName: | CHRISTOPHER | ||||||||
| MiddleName: | A. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7 GREENWOOD AVE | ||||||||
| Address2: | |||||||||
| City: | CONWAY | ||||||||
| State: | NH | ||||||||
| PostalCode: | 038186130 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6034473500 | ||||||||
| FaxNumber: | 6034473500 | ||||||||
| Practice Location | |||||||||
| Address1: | 7 GREENWOOD AVE | ||||||||
| Address2: | |||||||||
| City: | CONWAY | ||||||||
| State: | NH | ||||||||
| PostalCode: | 038186130 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6034473500 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/05/2018 | ||||||||
| LastUpdateDate: | 08/27/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 08/27/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | 1454 | NH | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.