| Northeast Gastroenterology Associates, Llc | |
|
2 Manor Pkwy Ste 5 Salem NH 03079-4871 | |
| (603) 898-5082 | |
| (603) 890-5453 |
| Full Name | Northeast Gastroenterology Associates, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2 Manor Pkwy Ste 5, Salem, New Hampshire |
| Authorized Official Name and Position | Nicholas Vailas (MANAGING MEMBER) |
| Authorized Official Contact | 6032324513 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Northeast Gastroenterology Associates, Llc 55 Bridge St Manchester NH 03101-1603 Ph: () - | Northeast Gastroenterology Associates, Llc 2 Manor Pkwy Ste 5 Salem NH 03079-4871 Ph: (603) 898-5082 |
| NPI Number | 1922199348 |
|---|---|
| Provider Enumeration Date | 09/28/2006 |
| Last Update Date | 05/17/2023 |
| Medicare PECOS PAC ID | 8123067998 |
|---|---|
| Medicare Enrollment ID | O20050502000045 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922199348 | NPI | - | NPPES |
| 697398 | Other | MA | TUFTS GROUP NUMBER |
| 9784594 | Medicaid | MA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | 60421 (Massachusetts) | Primary |
| Provider Name | Maurice B Cohen |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1851482277 PECOS PAC ID: 5395784169 Enrollment ID: I20060327000753 |
| Provider Name | Raja A Rehman |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1760573182 PECOS PAC ID: 2264456052 Enrollment ID: I20120803000038 |
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