Basic Information
| Provider Information | |||||||||
| NPI: | 1215354956 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TOUMA | ||||||||
| FirstName: | ALLISON | ||||||||
| MiddleName: | |||||||||
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| NameSuffix: | |||||||||
| Credential: | PA-C | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | MARCOTTE | ||||||||
| OtherFirstName: | ALLISON | ||||||||
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| OtherCredential: | PA-C | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 10 SYCAMORE AVE | ||||||||
| Address2: | |||||||||
| City: | SALEM | ||||||||
| State: | NH | ||||||||
| PostalCode: | 030792810 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9787583505 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 288 GROVELAND ST | ||||||||
| Address2: | |||||||||
| City: | HAVERHILL | ||||||||
| State: | MA | ||||||||
| PostalCode: | 018306674 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9783733851 | ||||||||
| FaxNumber: | 6037787964 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/19/2014 | ||||||||
| LastUpdateDate: | 08/24/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
| AuthorizedOfficialFirstName: | |||||||||
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| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
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| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | 08/24/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AS0400X | 1006 | NH | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Surgical |
ID Information
| ID | Type | State | Issuer | Description | 3096220 | 05 | NH | MEDICAID |