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NPI Code Detail

MEDICARE: FISICHELLI, BEACH & BRAR PROFESSIONAL ASSN.

MEDICARE: FISICHELLI, BEACH & BRAR PROFESSIONAL ASSN.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry3195NH

General Provider Information

NPI Number : 1689773426
Entity Type Code : Organization
Provider Name (Legal Business Name) : FISICHELLI, BEACH & BRAR PROFESSIONAL ASSN.
Provider Business Mailing Address
First Line : 33 BROAD ST
Second Line :
City : NASHUA
State : NH
Zip : 03064-2014
Country : US
Telephone Number : 603-889-0601
Fax Number : 603-889-3060
Provider Business Practice Location Address
First Line : 33 BROAD ST
Second Line :
City : NASHUA
State : NH
Zip : 03064-2014
Country : US
Telephone Number : 603-889-0601
Fax Number : 603-889-3060
Authorized Official
Title or Position : OWNER
Name : DR. HARJEET S BRAR
Credential : DDS
Telephone Number : 603-889-0601
Provider Enumeration Date : 09/21/2006
Last Update Date : 05/02/2017

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