Provider Demographics
NPI:1154397420
Name:ONKSEN, PHYLLIS M (PT)
Entity type:Individual
Prefix:
First Name:PHYLLIS
Middle Name:M
Last Name:ONKSEN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 ARMORY RD STE 3
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03055-3456
Mailing Address - Country:US
Mailing Address - Phone:603-673-0225
Mailing Address - Fax:603-673-4163
Practice Address - Street 1:17 ARMORY RD STE 3
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:NH
Practice Address - Zip Code:03055-3456
Practice Address - Country:US
Practice Address - Phone:603-673-0225
Practice Address - Fax:603-673-4163
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2008-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0177225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH10339OtherCIGNA HEALTHCARE PROVIDER
NH99908323Medicaid
NH080270Y0NH01OtherANTHEM BCBS PROVIDER NO.
NHUX0983Medicare UPIN