Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | 9146 | NH |
NPI | 1063406932 |
---|---|
Provider Name | Frederick M Briccetti |
First Address | Hooksett, NH 03106-2504 |
Second Address | Concord, NH 03301 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/09/2005 |
Last Update Date | 15/02/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
30006878 | (05) | NH |
F58445 | (02) | NH |