Provider Demographics
NPI:1518951250
Name:KANTER, ALYSE K (MD)
Entity Type:Individual
Prefix:
First Name:ALYSE
Middle Name:K
Last Name:KANTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 PROSPECT ST
Mailing Address - Street 2:SUITE 402
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03060-3922
Mailing Address - Country:US
Mailing Address - Phone:603-577-3131
Mailing Address - Fax:603-577-3132
Practice Address - Street 1:10 PROSPECT ST
Practice Address - Street 2:SUITE 402
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060-3922
Practice Address - Country:US
Practice Address - Phone:603-577-3131
Practice Address - Fax:603-577-3132
Is Sole Proprietor?:No
Enumeration Date:2005-09-08
Last Update Date:2008-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH11703207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH020456218OtherTAX ID
NH30203214Medicaid
NHG82477Medicare UPIN
NH160059070Medicare PIN
NH30203214Medicaid