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NPI Code Detail

MEDICARE: GREATER HAMPSTEAD FAMILY MEDICINE, INC.

MEDICARE: GREATER HAMPSTEAD FAMILY MEDICINE, INC.
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
1207L00000XAnesthesiology Physician
2367500000XCertified Registered Nurse Anesthetist
3207QS0010XSports Medicine (Family Medicine) Physician
4207Q00000XFamily Medicine Physician

General Provider Information

NPI Number : 1740379940
Entity Type Code : Organization
Provider Name (Legal Business Name) : GREATER HAMPSTEAD FAMILY MEDICINE, INC.
Provider Business Mailing Address
First Line : 55 BRIDGE ST
Second Line :
City : MANCHESTER
State : NH
Zip : 03101-1603
Country : US
Telephone Number : 603-232-4513
Fax Number : 603-232-4563
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 : 603-329-8016
Authorized Official
Title or Position : OWNER
Name : NICHOLAS VAILAS
Credential :
Telephone Number : 603-232-4513
Provider Enumeration Date : 10/12/2006
Last Update Date : 05/29/2025

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