Healthcare Provider Details

I. General information

NPI: 1205124757
Provider Name (Legal Business Name): ADAM PAUL ANDROLIA DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2011
Last Update Date: 03/19/2025
Certification Date: 03/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 TSIENNETO RD STE 100
DERRY NH
03038-1595
US

IV. Provider business mailing address

14B TSIENNETO RD
DERRY NH
03038-1560
US

V. Phone/Fax

Practice location:
  • Phone: 603-537-1300
  • Fax:
Mailing address:
  • Phone: 603-537-1300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number17044
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: