Provider Demographics
NPI:1023170529
Name:PHILLIP P FICHERA MD PC
Entity type:Organization
Organization Name:PHILLIP P FICHERA MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILLIP
Authorized Official - Middle Name:P
Authorized Official - Last Name:FICHERA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:603-598-2522
Mailing Address - Street 1:290 DERRY RD
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:NH
Mailing Address - Zip Code:03051-3000
Mailing Address - Country:US
Mailing Address - Phone:603-598-2522
Mailing Address - Fax:603-598-2533
Practice Address - Street 1:290 DERRY RD
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:NH
Practice Address - Zip Code:03051-3000
Practice Address - Country:US
Practice Address - Phone:603-598-2522
Practice Address - Fax:603-598-2533
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH8812207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty