| Organization Name: | GLENGAYNOR PSYCHOTHERAPY PRACTICE, LLC |
| NPI Number: | 1447393087 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JAMES JOHN GAYNOR (PSYCHIATRIC NURSE PRACTITIONER) |
| Mailing Address: | 120 Route 10 Sawyer Brook Plaza-suite 10 Grantham |
| State: | NH US |
| Postal Code: | 03753 |
| Phone Number: | 6038633788 |
| Fax Number: | 6038632753 |
| NPI Enumeration Date: | 02/14/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0808X |
| License Number: | 049181-23-08 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NH |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |