Provider Demographics
NPI:1912950593
Name:LAROUCHE, MONIQUE (MD)
Entity Type:Individual
Prefix:
First Name:MONIQUE
Middle Name:
Last Name:LAROUCHE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 HOLLAND WAY FL 1
Mailing Address - Street 2:
Mailing Address - City:EXETER
Mailing Address - State:NH
Mailing Address - Zip Code:03833-2937
Mailing Address - Country:US
Mailing Address - Phone:603-778-1620
Mailing Address - Fax:603-772-8015
Practice Address - Street 1:118 PORTSMOUTH AVE BLDG D
Practice Address - Street 2:
Practice Address - City:STRATHAM
Practice Address - State:NH
Practice Address - Zip Code:03885
Practice Address - Country:US
Practice Address - Phone:603-778-1620
Practice Address - Fax:603-772-8015
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2019-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH7913207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3075220Medicaid
NH30203223Medicaid
E83201Medicare UPIN