Healthcare Provider Details

I. General information

NPI: 1881224509
Provider Name (Legal Business Name): EXPRESSMED, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2020
Last Update Date: 10/16/2025
Certification Date: 10/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 KOSCIUSZKO ST
MANCHESTER NH
03101-1608
US

IV. Provider business mailing address

700 LAKE AVE STE 2
MANCHESTER NH
03103-2734
US

V. Phone/Fax

Practice location:
  • Phone: 603-627-8053
  • Fax:
Mailing address:
  • Phone: 603-621-0681
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0001X
TaxonomyClinical & Laboratory Immunology (Internal Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: MELINDA SILVERNALE
Title or Position: OPERATIONS MANAGER
Credential:
Phone: 603-621-0681