Provider Demographics
NPI:1003825407
Name:MASSEY, ROBERT (PA-C)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:MASSEY
Suffix:
Gender:M
Credentials:PA-C
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Mailing Address - Street 1:360 US HIGHWAY 1 BYP UNIT 102
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-7105
Mailing Address - Country:US
Mailing Address - Phone:603-410-6700
Mailing Address - Fax:603-319-8308
Practice Address - Street 1:42 NASHUA ROAD
Practice Address - Street 2:
Practice Address - City:LONDONDERRY
Practice Address - State:NH
Practice Address - Zip Code:03053
Practice Address - Country:US
Practice Address - Phone:603-413-6800
Practice Address - Fax:603-413-6803
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2023-11-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NH0286363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME434457299Medicaid
000000042892OtherBMC HEALTHNET PLAN
NH30330237Medicaid
P00166939OtherRAILROAD MEDICARE
ME434457299Medicaid
NH30330237Medicaid