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NPI Code Detail

MEDICARE: NEW ENGLAND NEUROVASCULAR ASSOCIATES PLLC

MEDICARE: NEW ENGLAND NEUROVASCULAR ASSOCIATES PLLC
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
12085N0700XNeuroradiology Physician

General Provider Information

NPI Number : 1932043627
Entity Type Code : Organization
Provider Name (Legal Business Name) : NEW ENGLAND NEUROVASCULAR ASSOCIATES PLLC
Provider Business Mailing Address
First Line : REGISTERED AGENTS INC, 84 W BROADWAY, STE 200
Second Line :
City : DERRY
State : NH
Zip : 03038
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 333 BORTHWICK AVE
Second Line :
City : PORTSMOUTH
State : NH
Zip : 03801-7128
Country : US
Telephone Number : 617-546-1976
Fax Number :
Authorized Official
Title or Position : MANAGER
Name : AJIT S PURI
Credential : MD
Telephone Number : 617-543-5882
Provider Enumeration Date : 04/15/2026
Last Update Date : 06/11/2026

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