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NPI Code Detail

MEDICARE: DR. EDWARD A FISICHELLI DDS

MEDICARE: DR. EDWARD A FISICHELLI DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry1081NH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1184723058
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. EDWARD A FISICHELLI DDS
Provider Business Mailing Address
First Line : 33 BROAD ST
Second Line :
City : NASHUA
State : NH
Zip : 03064-2014
Country : US
Telephone Number : 603-889-0601
Fax Number : 603-889-3060
Provider Business Practice Location Address
First Line : 33 BROAD ST
Second Line :
City : NASHUA
State : NH
Zip : 03064-2014
Country : US
Telephone Number : 603-889-0601
Fax Number : 603-889-3060
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/21/2006
Last Update Date : 07/09/2007

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Directions to “ DR. EDWARD A FISICHELLI DDS” Practice Location

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