Healthcare Provider Details

I. General information

NPI: 1548338726
Provider Name (Legal Business Name): RICHARD E. FRADETTE RPH, MPH, JD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/04/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

166 N GATE RD
MANCHESTER NH
03104-1825
US

IV. Provider business mailing address

166 N GATE RD
MANCHESTER NH
03104-1825
US

V. Phone/Fax

Practice location:
  • Phone: 603-624-8511
  • Fax: 603-623-4817
Mailing address:
  • Phone: 603-624-8511
  • Fax: 603-623-4817

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number2135
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: