Provider Demographics
NPI:1508883349
Name:ABAID, STACEY PAMELA (PA-C)
Entity Type:Individual
Prefix:
First Name:STACEY
Middle Name:PAMELA
Last Name:ABAID
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 ARMORY RD
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03055-3405
Mailing Address - Country:US
Mailing Address - Phone:603-673-2515
Mailing Address - Fax:
Practice Address - Street 1:14 ARMORY RD
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:NH
Practice Address - Zip Code:03055-3405
Practice Address - Country:US
Practice Address - Phone:603-673-2515
Practice Address - Fax:603-673-8043
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2012-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH396363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30331637Medicaid
NHAP1559Medicare PIN
NHP42586Medicare UPIN