Provider Demographics
NPI:1780648261
Name:NEW ENGLAND NEPHROLOGY & HYPERTENSION ASSOCIATES, P.L.L.C.
Entity Type:Organization
Organization Name:NEW ENGLAND NEPHROLOGY & HYPERTENSION ASSOCIATES, P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:MATTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-430-7300
Mailing Address - Street 1:230 LAFAYETTE RD
Mailing Address - Street 2:BLDG. C, SUITE 4
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-5465
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:230 LAFAYETTE RD
Practice Address - Street 2:BLDG. C, SUITE 4
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-5465
Practice Address - Country:US
Practice Address - Phone:603-430-7300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH9841174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty