Provider Demographics
NPI:1801971080
Name:ILNICZKY, NORA
Entity type:Individual
Prefix:
First Name:NORA
Middle Name:
Last Name:ILNICZKY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 WATER ST
Mailing Address - Street 2:
Mailing Address - City:EXETER
Mailing Address - State:NH
Mailing Address - Zip Code:03833-2456
Mailing Address - Country:US
Mailing Address - Phone:603-691-7420
Mailing Address - Fax:
Practice Address - Street 1:127 WATER ST
Practice Address - Street 2:
Practice Address - City:EXETER
Practice Address - State:NH
Practice Address - Zip Code:03833-2456
Practice Address - Country:US
Practice Address - Phone:603-691-7420
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2025-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH6904103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAW10533OtherBLUE CROSS BLUE SHIELD