Healthcare Provider Details

I. General information

NPI: 1720159213
Provider Name (Legal Business Name): CARRIE DECATO AYERS DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CARRIE ANNE DECATO DO

II. Dates (important events)

Enumeration Date: 11/13/2006
Last Update Date: 01/23/2023
Certification Date: 01/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 PILLSBURY ST SUITE 202
CONCORD NH
03301-3556
US

IV. Provider business mailing address

1 PILLSBURY ST SUITE 202
CONCORD NH
03301-3556
US

V. Phone/Fax

Practice location:
  • Phone: 603-224-4476
  • Fax: 603-228-2113
Mailing address:
  • Phone: 603-224-4476
  • Fax: 603-228-2113

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number15613
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: