Basic Information
Provider Information
NPI: 1609983782
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KADIQI
FirstName: KLEVIS
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 250 PLEASANT ST
Address2:  
City: CONCORD
State: NH
PostalCode: 033017539
CountryCode: US
TelephoneNumber: 6032277000
FaxNumber: 6032277191
Practice Location
Address1: 250 PLEASANT ST
Address2:  
City: CONCORD
State: NH
PostalCode: 033017539
CountryCode: US
TelephoneNumber: 6032277000
FaxNumber: 6032277191
Other Information
ProviderEnumerationDate: 08/24/2006
LastUpdateDate: 04/10/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X13211NHN Allopathic & Osteopathic PhysiciansInternal Medicine 
208M00000X13211NHY Allopathic & Osteopathic PhysiciansHospitalist 

No ID Information.


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