Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 17044 | NH |
N | 207Q00000X | Family Doctor | LL1486 | SC |
N | 207QS0010X | Family Doctor - Sports Medicine | 17044 | NH |
NPI | 1205124757 |
---|---|
Provider Name | Adam Paul Androlia |
First Address | Londonderry, NH 03053-3417 |
Second Address | Derry, NH 03038-1595 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2011 |
Last Update Date | 30/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3101743 | (05) | NH |