Provider Demographics
NPI:1548338726
Name:FRADETTE, RICHARD E (RPH, MPH, JD)
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:E
Last Name:FRADETTE
Suffix:
Gender:M
Credentials:RPH, MPH, JD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:166 N GATE RD
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03104-1825
Mailing Address - Country:US
Mailing Address - Phone:603-624-8511
Mailing Address - Fax:603-623-4817
Practice Address - Street 1:166 N GATE RD
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03104-1825
Practice Address - Country:US
Practice Address - Phone:603-624-8511
Practice Address - Fax:603-623-4817
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
173000000X
NH2135183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered173000000XOther Service ProvidersLegal Medicine
Not Answered183500000XPharmacy Service ProvidersPharmacist