Healthcare Provider Details

I. General information

NPI: 1215958418
Provider Name (Legal Business Name): NORMAN KOSSAYDA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2006
Last Update Date: 07/17/2023
Certification Date: 07/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

172 KINSLEY ST
NASHUA NH
03060-3648
US

IV. Provider business mailing address

380 LAFAYETTE RD
HAMPTON NH
03842-2222
US

V. Phone/Fax

Practice location:
  • Phone: 603-595-3061
  • Fax: 603-889-3774
Mailing address:
  • Phone: 603-926-0088
  • Fax: 603-926-2853

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number7087
License Number StateNH
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number45646
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: