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General NPI Number Information
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NPI Number | 1851192306
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Entity Type | Organization
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Legal Business Name | NORTHEAST MEDICAL INFUSION CENTER LLC
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Dates
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Enumeration Date | 03/21/2025
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Last Update Date | 10/20/2025
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Provider Practice Location Address
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Address Line | 155 MAIN DUNSTABLE RD STE 140
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City | NASHUA
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State | NH
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Zip | 03060-3666
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Country | US
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Telephone | 978-809-4155
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Fax |
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Provider Business Mailing Address
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Address Line | 155 MAIN DUNSTABLE RD STE 140
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City | NASHUA
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State | NH
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Zip | 03060-3666
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Country | US
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Telephone | 978-809-4155
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Fax |
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Authorized Official
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Title or Position | MD
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Name | MASOOMA ATHAR
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Credential |
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Telephone | 978-809-4155
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QI0500X
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Taxonomy Name | Infusion Therapy Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 163WI0500X
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Taxonomy Name | Infusion Therapy Registered Nurse
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number |
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License Number State |
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