Healthcare Provider Details

I. General information

NPI: 1477363570
Provider Name (Legal Business Name): ABBY MARRAZZO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2025
Last Update Date: 01/10/2025
Certification Date: 01/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 MCGREGOR ST
MANCHESTER NH
03102-3730
US

IV. Provider business mailing address

195 MCGREGOR ST APT 219
MANCHESTER NH
03102-3775
US

V. Phone/Fax

Practice location:
  • Phone: 603-663-5282
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number111175-21
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: