Healthcare Provider Details

I. General information

NPI: 1578183992
Provider Name (Legal Business Name): ANDRES AGUILERA-FISH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2020
Last Update Date: 07/18/2023
Certification Date: 07/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 MOUNT EUSTIS RD
LITTLETON NH
03561-3712
US

IV. Provider business mailing address

25 MOUNT EUSTIS RD
LITTLETON NH
03561-3712
US

V. Phone/Fax

Practice location:
  • Phone: 603-444-2464
  • Fax:
Mailing address:
  • Phone: 603-444-2464
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number24250
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: