Provider Demographics
NPI:1821421942
Name:NP SKINCARE
Entity Type:Organization
Organization Name:NP SKINCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LENORE
Authorized Official - Middle Name:S
Authorized Official - Last Name:CROSSON
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:860-324-0844
Mailing Address - Street 1:31 MAGNOLIA DR
Mailing Address - Street 2:
Mailing Address - City:SUFFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06078-1551
Mailing Address - Country:US
Mailing Address - Phone:860-324-0844
Mailing Address - Fax:
Practice Address - Street 1:113 ELM ST
Practice Address - Street 2:SUITE 304
Practice Address - City:ENFIELD
Practice Address - State:CT
Practice Address - Zip Code:06082-3700
Practice Address - Country:US
Practice Address - Phone:860-272-4638
Practice Address - Fax:860-741-2229
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-12
Last Update Date:2013-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002480174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty