MEDICARE: DR. SHARON L DELLA GROTTA M.D.

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
1	208000000X	Pediatrics Physician	7306	NH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	0105521YPNH01	OTHER	NH	BLUE SHIELD PROVIDER NO

General Provider Information

NPI Number	:	1619931235
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHARON L DELLA GROTTA M.D.

Provider Business Mailing Address
First Line	:	58 HAWTHORNE DR
Second Line	:
City	:	BEDFORD
State	:	NH
Zip	:	03110-6912
Country	:	US
Telephone Number	:	603-622-8619
Fax Number	:

Provider Business Practice Location Address
First Line	:	58 HAWTHORNE DR
Second Line	:
City	:	BEDFORD
State	:	NH
Zip	:	03110-6912
Country	:	US
Telephone Number	:	603-622-8619
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/12/2006
Last Update Date	:	01/12/2026

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