Healthcare Provider Details

I. General information

NPI: 1588679302
Provider Name (Legal Business Name): ASSOCIATED FAMILY FOOT CARE CENTERS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2006
Last Update Date: 10/02/2023
Certification Date: 10/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

875 GREENLAND RD UNIT C4
PORTSMOUTH NH
03801-4163
US

IV. Provider business mailing address

PO BOX 712
NORTH HAMPTON NH
03862-0712
US

V. Phone/Fax

Practice location:
  • Phone: 603-964-6555
  • Fax: 603-964-6515
Mailing address:
  • Phone: 603-964-6555
  • Fax: 603-964-6515

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State

VIII. Authorized Official

Name: BRIAN A NAGY
Title or Position: OWNER
Credential: DPM
Phone: 603-964-6555