Healthcare Provider Details
I. General information
NPI: 1568373124
Provider Name (Legal Business Name): NORTHEAST ORTHOPAEDIC ALLIANCE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/14/2026
Last Update Date: 09/17/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7 INDIAN ROCK RD STE F
WINDHAM NH
03087
US
IV. Provider business mailing address
PO BOX 791835
BALTIMORE MD
21279-1835
US
V. Phone/Fax
- Phone: 603-883-0091
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JOHN
R
CORSETTI
Title or Position: PRESIDENT
Credential:
Phone: 413-785-4666