Healthcare Provider Details

I. General information

NPI: 1750275475
Provider Name (Legal Business Name): NICOLAS HELLER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2025
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17 PROSPECT ST
NASHUA NH
03060-3956
US

IV. Provider business mailing address

17 PROSPECT ST
NASHUA NH
03060-3956
US

V. Phone/Fax

Practice location:
  • Phone: 603-577-2663
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number3718
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: