1861410045 NPI number — DR. ALICIA J FRANK PHD

Table of content: DR. ALICIA J FRANK PHD (NPI 1861410045)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861410045 NPI number — DR. ALICIA J FRANK PHD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FRANK
Provider First Name:
ALICIA
Provider Middle Name:
J
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1861410045
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/28/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1465 HOOKSETT RD UNIT 274
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOOKSETT
Provider Business Mailing Address State Name:
NH
Provider Business Mailing Address Postal Code:
03106-1881
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NASHUA
Provider Business Practice Location Address State Name:
NH
Provider Business Practice Location Address Postal Code:
03064-2716
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
603-883-0005
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/17/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103TC0700X , with the licence number:  048-0000839 , registered in the state of VT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 103TC2200X , with the licence number: 1134 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 68016 . This is a "BCBS" identifier , issued by the state of ( VT ) . This identifiers is of the category "OTHER".
  • Identifier: 2193483 . This is a "CIGNA" identifier , issued by the state of ( VT ) . This identifiers is of the category "OTHER".
  • Identifier: 559197 . This is a "VALUE OPTIONS" identifier , issued by the state of ( VT ) . This identifiers is of the category "OTHER".
  • Identifier: 1010568 , issued by the state of ( VT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 356531 . This is a "MHN" identifier , issued by the state of ( VT ) . This identifiers is of the category "OTHER".