Healthcare Provider Details

I. General information

NPI: 1528063864
Provider Name (Legal Business Name): NEW ENGLAND BRACE CO., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/14/2005
Last Update Date: 02/23/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 BRACE AVE
HOOKSETT NH
03106-1109
US

IV. Provider business mailing address

10 BRACE AVE
HOOKSETT NH
03106-1109
US

V. Phone/Fax

Practice location:
  • Phone: 603-668-8360
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VII. Legacy identifiers

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

# 1
Identifier1002782
Identifier TypeMEDICAID
Identifier StateVT
Identifier Issuer
# 2
Identifier1207363Y0NH01
Identifier TypeOTHER
Identifier StateNH
Identifier IssuerBCBS
# 3
Identifier4696
Identifier TypeOTHER
Identifier StateNH
Identifier IssuerCIGNA
# 4
Identifier138580004
Identifier TypeMEDICAID
Identifier StateME
Identifier Issuer
# 5
Identifier80009455
Identifier TypeMEDICAID
Identifier StateNH
Identifier Issuer
# 6
Identifier700383
Identifier TypeOTHER
Identifier StateNH
Identifier IssuerHARVARD PILGRIM

VIII. Authorized Official

Name: MR. PAUL W. GUIMOND
Title or Position: PRESIDENT
Credential: C.O.
Phone: 603-668-8360