Provider Demographics
NPI:1336918044
Name:AERIE HEALTHCARE LLC
Entity Type:Organization
Organization Name:AERIE HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/CO-CEO
Authorized Official - Prefix:
Authorized Official - First Name:MIKLOS
Authorized Official - Middle Name:
Authorized Official - Last Name:OYLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-986-3356
Mailing Address - Street 1:PO BOX 2685
Mailing Address - Street 2:
Mailing Address - City:NORTH CONWAY
Mailing Address - State:NH
Mailing Address - Zip Code:03860-2685
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:33 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-4004
Practice Address - Country:US
Practice Address - Phone:603-986-3356
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-21
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health