Provider Demographics
NPI:1568801165
Name:NEUROPATHY COMFORT CENTER OF NEW ENGLAND LLC
Entity Type:Organization
Organization Name:NEUROPATHY COMFORT CENTER OF NEW ENGLAND LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER / DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:GORVEATT
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:603-552-3309
Mailing Address - Street 1:25 NASHUA RD
Mailing Address - Street 2:SUITE E1
Mailing Address - City:LONDONDERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03053-3446
Mailing Address - Country:US
Mailing Address - Phone:603-552-3309
Mailing Address - Fax:603-965-4177
Practice Address - Street 1:25 NASHUA RD
Practice Address - Street 2:SUITE E1
Practice Address - City:LONDONDERRY
Practice Address - State:NH
Practice Address - Zip Code:03053-3446
Practice Address - Country:US
Practice Address - Phone:603-552-3309
Practice Address - Fax:603-965-4177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-18
Last Update Date:2013-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH05965623174400000X
NH059656-23363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1720129406OtherNPI SINGLE
NHP70812Medicare UPIN