1417928334 NPI number — DR. FREDERICK R ARONSON MD

Table of content: DR. FREDERICK R ARONSON MD (NPI 1417928334)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1417928334 NPI number — DR. FREDERICK R ARONSON MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ARONSON
Provider First Name:
FREDERICK
Provider Middle Name:
R
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

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:
1417928334
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/03/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
P.O. BOX 911
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BRATTLEBORO
Provider Business Mailing Address State Name:
VT
Provider Business Mailing Address Postal Code:
05302
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
207-396-7600
Provider Business Mailing Address Fax Number:
207-396-7986

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
100 CAMPUS DRIVE
Provider Second Line Business Practice Location Address:
SUITE 108
Provider Business Practice Location Address City Name:
SCARBOROUGH
Provider Business Practice Location Address State Name:
ME
Provider Business Practice Location Address Postal Code:
04074
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
207-396-7600
Provider Business Practice Location Address Fax Number:
207-396-7986
Provider Enumeration Date:
01/30/2006

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: 207RH0003X , with the licence number:  13558 , registered in the state of ME ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 007134 . This is a "ANTHEM BCBS" identifier , issued by the state of ( ME ) . This identifiers is of the category "OTHER".
  • Identifier: 2017591 . This is a "AETNA HMO" identifier , issued by the state of ( ME ) . This identifiers is of the category "OTHER".
  • Identifier: 291220099 , issued by the state of ( ME ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4034357 . This is a "AETNA" identifier , issued by the state of ( ME ) . This identifiers is of the category "OTHER".
  • Identifier: 6425279 . This is a "CIGNA" identifier , issued by the state of ( ME ) . This identifiers is of the category "OTHER".
  • Identifier: 30005898 , issued by the state of ( NH ) . This identifiers is of the category "MEDICAID".




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