Provider Demographics
NPI:1841238573
Name:NIEGISCH, ROBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:
Last Name:NIEGISCH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 PEMBROKE ST
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE
Mailing Address - State:NH
Mailing Address - Zip Code:03275-1311
Mailing Address - Country:US
Mailing Address - Phone:603-485-8441
Mailing Address - Fax:603-485-7718
Practice Address - Street 1:121 PEMBROKE ST
Practice Address - Street 2:
Practice Address - City:PEMBROKE
Practice Address - State:NH
Practice Address - Zip Code:03275-1311
Practice Address - Country:US
Practice Address - Phone:603-485-8441
Practice Address - Fax:603-485-7718
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2015-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH7624207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHB86201Medicare UPIN