Provider Demographics
NPI:1528001377
Name:FINOCCHIARO, CAROLYN (NP)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:
Last Name:FINOCCHIARO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:72 RIDDLE DR
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03110-5321
Mailing Address - Country:US
Mailing Address - Phone:603-494-3180
Mailing Address - Fax:
Practice Address - Street 1:306 RIVERWAY PL
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:NH
Practice Address - Zip Code:03110-6764
Practice Address - Country:US
Practice Address - Phone:603-494-3180
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-13
Last Update Date:2007-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0445632305363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30343548Medicaid
NHP21827Medicare UPIN
NHNP2971Medicare ID - Type Unspecified