1689872681 NPI number — AMY MACE SLP

Table of content: AMY MACE SLP (NPI 1689872681)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1689872681 NPI number — AMY MACE SLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MACE
Provider First Name:
AMY
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
SLP
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:
1689872681
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/11/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
144 CANAL ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NASHUA
Provider Business Mailing Address State Name:
NH
Provider Business Mailing Address Postal Code:
03064-2886
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
603-882-6333
Provider Business Mailing Address Fax Number:
603-889-5460

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
144 CANAL 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:
03064-2886
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
603-882-6333
Provider Business Practice Location Address Fax Number:
603-889-5460
Provider Enumeration Date:
07/11/2007

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: 235Z00000X , with the licence number:  0666 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 761242 . This is a "TUFTS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 99560056 , issued by the state of ( NH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 626514 . This is a "HARVARD PILGRIM HEALTH CA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0561822 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 272746 . This is a "CIGNA NH" identifier . This identifiers is of the category "OTHER".