Provider Demographics
NPI:1265480958
Name:ASLAM, NAILA (OD)
Entity Type:Individual
Prefix:
First Name:NAILA
Middle Name:
Last Name:ASLAM
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 BELKNAP ST STE 1
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03820-3643
Mailing Address - Country:US
Mailing Address - Phone:603-742-5719
Mailing Address - Fax:603-743-5811
Practice Address - Street 1:65 BELKNAP ST STE 1
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:NH
Practice Address - Zip Code:03820-3643
Practice Address - Country:US
Practice Address - Phone:603-742-5719
Practice Address - Fax:603-743-5811
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEOPT843152WC0802X
NH0723152W00000X, 152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30352588Medicaid
ME321760099Medicaid
NH30352588Medicaid
MEMM9411Medicare PIN
NHRE7289Medicare PIN