Basic Information
Provider Information
NPI: 1023088713
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ARONSON
FirstName: MARK
MiddleName: J
NamePrefix:  
NameSuffix:  
Credential: DO
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 1327
Address2:  
City: LACONIA
State: NH
PostalCode: 032471327
CountryCode: US
TelephoneNumber: 6035243211
FaxNumber: 6035277038
Practice Location
Address1: 85 SPRING ST
Address2:  
City: LACONIA
State: NH
PostalCode: 032463113
CountryCode: US
TelephoneNumber: 6035272969
FaxNumber: 6035272858
Other Information
ProviderEnumerationDate: 01/25/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000X6687NHY Allopathic & Osteopathic PhysiciansFamily Medicine 

ID Information
IDTypeStateIssuerDescription
341276301NHAETNAOTHER
B5793501NHHARVARD PILGRIM HEALTHCAROTHER
0400503YPNH0101NHANTHEMOTHER
683274901NHCIGNAOTHER
8208050305NH MEDICAID
38379801NHMVPOTHER


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