Provider Demographics
NPI:1679913016
Name:PINKHAM, ASJA A (OD)
Entity Type:Individual
Prefix:DR
First Name:ASJA
Middle Name:A
Last Name:PINKHAM
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:ASJA
Other - Middle Name:
Other - Last Name:ASCERIC
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:764 2ND ST
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03102-5210
Mailing Address - Country:US
Mailing Address - Phone:603-669-3925
Mailing Address - Fax:603-669-0380
Practice Address - Street 1:764 2ND ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03102-5210
Practice Address - Country:US
Practice Address - Phone:603-669-3925
Practice Address - Fax:603-669-0380
Is Sole Proprietor?:No
Enumeration Date:2013-06-30
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0876152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist