Provider Demographics
NPI:1558337139
Name:NEMETZ, ALAN (PHD)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:
Last Name:NEMETZ
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 OLD DOVER RD
Mailing Address - Street 2:SUITE ONE
Mailing Address - City:ROCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03867-3460
Mailing Address - Country:US
Mailing Address - Phone:603-335-2444
Mailing Address - Fax:603-335-2226
Practice Address - Street 1:1 OLD DOVER RD
Practice Address - Street 2:SUITE ONE
Practice Address - City:ROCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03867-3460
Practice Address - Country:US
Practice Address - Phone:603-335-2444
Practice Address - Fax:603-335-2226
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH603103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH0600307Y0NH01OtherANTHEM
NH30004845Medicaid
NH0600307Y0NH01OtherANTHEM
S18964Medicare UPIN