Individual
DR. LEONARD WASSERMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
168 KINSLEY ST STE 20, NASHUA, NH 03060-3634
(603) 883-3365
(603) 883-5758
Mailing address
C/O ST MARY'S PROVIDER ENROLLMENT - PROVIDER ENROLLMENT, PO BOX 7291, LEWISTON, ME 04243-7291
(207) 777-8695
(207) 777-8800
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
6838
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30005497
—
NH
05
—
3076900
—
NH
01
—
P01630313
RAILROAD MEDICARE
NH
Enumeration date
12/21/2005
Last updated
09/01/2020
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