Provider Demographics
NPI:1871688291
Name:DIPARDO, CAROLE MARIE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:CAROLE
Middle Name:MARIE
Last Name:DIPARDO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:CAROLE
Other - Middle Name:MARIE
Other - Last Name:MARQUIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:246 PLEASANT ST.
Mailing Address - Street 2:MEMORIAL BUILDING, WEST, GROUND FLOOR
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-2548
Mailing Address - Country:US
Mailing Address - Phone:603-224-1725
Mailing Address - Fax:603-227-7557
Practice Address - Street 1:246 PLEASANT ST.
Practice Address - Street 2:MEMORIAL BUILDING, WEST, GROUND FLOOR
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-0330
Practice Address - Country:US
Practice Address - Phone:603-224-1725
Practice Address - Fax:603-227-7557
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1072363AM0700X, 363AS0400X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI979005932Medicare PIN