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NPI Code Detail

MEDICARE: AMY HASELFELD PA-C

MEDICARE: AMY HASELFELD PA-C
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
1363A00000XPhysician Assistant0659NH

General Provider Information

NPI Number : 1669659447
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMY HASELFELD PA-C
Provider Business Mailing Address
First Line : 207 STAGE RD
Second Line :
City : HAMPSTEAD
State : NH
Zip : 03841-2224
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 207 STAGE RD
Second Line :
City : HAMPSTEAD
State : NH
Zip : 03841-2224
Country : US
Telephone Number : 603-329-5222
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/24/2008
Last Update Date : 01/24/2008

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