Provider Demographics
NPI:1912064890
Name:AUBREY, PHILIP (OD)
Entity type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:
Last Name:AUBREY
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:81 MONT VERNON RD
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03055-4123
Mailing Address - Country:US
Mailing Address - Phone:603-673-1330
Mailing Address - Fax:603-673-7007
Practice Address - Street 1:81 MONT VERNON RD
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:NH
Practice Address - Zip Code:03055-4123
Practice Address - Country:US
Practice Address - Phone:603-673-1330
Practice Address - Fax:603-673-7007
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2008-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHNH371152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH80587889Medicaid
0569510001Medicare PIN
NH80587889Medicaid