Provider Demographics
NPI:1144920646
Name:AYMAT, ALICIA
Entity type:Individual
Prefix:
First Name:ALICIA
Middle Name:
Last Name:AYMAT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NEWMARKET
Mailing Address - State:NH
Mailing Address - Zip Code:03857-1835
Mailing Address - Country:US
Mailing Address - Phone:603-883-1626
Mailing Address - Fax:
Practice Address - Street 1:22 PROSPECT ST
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060-3924
Practice Address - Country:US
Practice Address - Phone:603-883-1628
Practice Address - Fax:603-816-1039
Is Sole Proprietor?:No
Enumeration Date:2023-03-06
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH083495-21163W00000X
MARN2345868163W00000X
NH083495-23363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse