Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 10045 | NH |
N | 111NI0900X | Internist | 10045 | NH |
Y | 207RA0401X | Internist - Addiction Medicine | 10045 | NH |
NPI | 1164408498 |
---|---|
Provider Name | Dr. Boris Golosarsky |
First Address | Nashua, NH 03061-3677 |
Second Address | Nashua, NH 03063-1259 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/12/2005 |
Last Update Date | 03/08/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
30010846 | (05) | NH |
3074148 | (05) | NH |
G52328 | (02) | NH |