Provider Demographics
NPI:1225488463
Name:PARADIS, ALLISON
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:PARADIS
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 1:391 CHESTER RD
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:NH
Mailing Address - Zip Code:03032-3504
Mailing Address - Country:US
Mailing Address - Phone:603-548-6679
Mailing Address - Fax:
Practice Address - Street 1:177 MAMMOTH RD
Practice Address - Street 2:
Practice Address - City:LONDONDERRY
Practice Address - State:NH
Practice Address - Zip Code:03053-3208
Practice Address - Country:US
Practice Address - Phone:603-432-2657
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-19
Last Update Date:2016-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH3428183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist