Provider Demographics
NPI:1619420601
Name:MOLLICA, ALISON
Entity Type:Individual
Prefix:MRS
First Name:ALISON
Middle Name:
Last Name:MOLLICA
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 1:628 LAFAYETTE RD
Mailing Address - Street 2:
Mailing Address - City:SEABROOK
Mailing Address - State:NH
Mailing Address - Zip Code:03874-4213
Mailing Address - Country:US
Mailing Address - Phone:603-474-9511
Mailing Address - Fax:603-474-9406
Practice Address - Street 1:628 LAFAYETTE RD
Practice Address - Street 2:
Practice Address - City:SEABROOK
Practice Address - State:NH
Practice Address - Zip Code:03874-4213
Practice Address - Country:US
Practice Address - Phone:603-474-9511
Practice Address - Fax:603-474-9406
Is Sole Proprietor?:No
Enumeration Date:2016-07-26
Last Update Date:2016-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH3308183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist