Healthcare Provider Details

I. General information

NPI: 1477472330
Provider Name (Legal Business Name): NICHOLAS BOCCIA
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 OAK RIDGE RD
NOTTINGHAM NH
03290-5622
US

IV. Provider business mailing address

1 OAK RIDGE RD
NOTTINGHAM NH
03290-5622
US

V. Phone/Fax

Practice location:
  • Phone: 603-490-4174
  • Fax:
Mailing address:
  • Phone: 603-490-4174
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number111142-21
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: