Healthcare Provider Details

I. General information

NPI: 1669796546
Provider Name (Legal Business Name): ANDREA M BERRY DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2010
Last Update Date: 10/24/2025
Certification Date: 10/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

280 PLEASANT ST
CONCORD NH
03301-2553
US

IV. Provider business mailing address

280 PLEASANT ST STE 1
CONCORD NH
03301-2553
US

V. Phone/Fax

Practice location:
  • Phone: 603-622-8665
  • Fax:
Mailing address:
  • Phone: 603-622-8665
  • Fax: 833-413-4978

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number15470
License Number StateNH
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number15470
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: