Healthcare Provider Details

I. General information

NPI: 1083657530
Provider Name (Legal Business Name): JOHN C. BASSI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2006
Last Update Date: 07/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 PLEASANT ST
CONCORD NH
03301-7539
US

IV. Provider business mailing address

19 FARRINGTON CORNER RD
HOPKINTON NH
03229-2020
US

V. Phone/Fax

Practice location:
  • Phone: 603-227-7140
  • Fax: 603-227-7187
Mailing address:
  • Phone: 603-228-7575
  • Fax: 603-228-7585

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number10480
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: