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General NPI Number Information
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NPI Number | 1962016808
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Entity Type | Organization
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Legal Business Name | ALTRIX PRIMARY CARE - NASHUA LLC
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Dates
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Enumeration Date | 09/08/2020
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Last Update Date | 05/27/2025
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Provider Practice Location Address
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Address Line | 57 NORTHEASTERN BLVD
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City | NASHUA
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State | NH
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Zip | 03062-3121
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Country | US
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Telephone | 908-219-7628
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 5
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City | KENDALL PARK
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State | NJ
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Zip | 08824-0005
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Country | US
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Telephone | 908-884-8482
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATIVE DIRECTOR
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Name | JENNIFER L VIOLA
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Credential |
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Telephone | 908-884-8482
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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