MEDICARE: DR. JOHN PATRICK AGUILAR SIA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RN0300X	Nephrology Physician	17413	NH

General Provider Information

NPI Number	:	1255597464
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN PATRICK AGUILAR SIA MD

Provider Business Mailing Address
First Line	:	1750 ELM STREET
Second Line	:	SUITE 201C
City	:	MANCHESTER
State	:	NH
Zip	:	03104-2903
Country	:	US
Telephone Number	:	603-621-2948
Fax Number	:	603-621-4126

Provider Business Practice Location Address
First Line	:	1750 ELM STREET
Second Line	:	SUITE 201C
City	:	MANCHESTER
State	:	NH
Zip	:	03104-2903
Country	:	US
Telephone Number	:	603-621-2948
Fax Number	:	603-621-4126

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/06/2008
Last Update Date	:	04/28/2016

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