Healthcare Provider Details

I. General information

NPI: 1841479433
Provider Name (Legal Business Name): NATE F DELISI DO PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/30/2007
Last Update Date: 09/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 KIMBALL DR UNIT 127
HOOKSETT NH
03106-2604
US

IV. Provider business mailing address

11 KIMBALL DR UNIT 127
HOOKSETT NH
03106-2604
US

V. Phone/Fax

Practice location:
  • Phone: 603-626-7900
  • Fax: 603-626-1780
Mailing address:
  • Phone: 603-626-7900
  • Fax: 603-626-1780

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License Number7313
License Number StateNH

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. NATE F DELISI
Title or Position: SOLE DIRECTOR
Credential: D.O.
Phone: 603-626-7900