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General NPI Number Information
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NPI Number | 1720103864
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Entity Type | Organization
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Legal Business Name | NASHUA PODIATRY ASSOCIATES, PLLC
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Dates
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Enumeration Date | 03/20/2007
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Last Update Date | 02/03/2010
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Provider Practice Location Address
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Address Line | 166 KINSLEY ST STE 201
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City | NASHUA
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State | NH
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Zip | 03060-3676
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Country | US
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Telephone | 603-880-9177
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Fax | 603-880-9672
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Provider Business Mailing Address
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Address Line | 166 KINSLEY ST STE 201
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City | NASHUA
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State | NH
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Zip | 03060-3676
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Country | US
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Telephone | 603-880-9177
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Fax | 603-880-9672
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Authorized Official
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Title or Position | DIRECT OWNER
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Name | MR. DAVID ROSS KOSOFSKY
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Credential | DPM
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Telephone | 603-880-9177
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | NH166
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License Number State | NH
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