Organization
NORTHEAST GASTROENTEROLOGY ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICHOLAS VAILAS (MANAGING MEMBER)
(603) 232-4513
Entity
Organization
Contact information
Practice address
2 MANOR PKWY STE 5, SALEM, NH 03079-4871
(603) 898-5082
(603) 890-5453
Mailing address
55 BRIDGE ST, MANCHESTER, NH 03101-1603
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
60421
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
697398
TUFTS GROUP NUMBER
MA
05
—
9784594
—
MA
Enumeration date
09/28/2006
Last updated
05/17/2023
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