Basic Information
| Provider Information | |||||||||
| NPI: | 1841260627 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CROSBY | ||||||||
| FirstName: | CAROLYN | ||||||||
| MiddleName: | S | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1327 | ||||||||
| Address2: | |||||||||
| City: | LACONIA | ||||||||
| State: | NH | ||||||||
| PostalCode: | 032471327 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6035243211 | ||||||||
| FaxNumber: | 6035277038 | ||||||||
| Practice Location | |||||||||
| Address1: | 238 DANIEL WEBSTER HWY | ||||||||
| Address2: | |||||||||
| City: | MEREDITH | ||||||||
| State: | NH | ||||||||
| PostalCode: | 032535803 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6032797464 | ||||||||
| FaxNumber: | 6032798467 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/25/2006 | ||||||||
| LastUpdateDate: | 05/05/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/05/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 9885 | NH | N | Allopathic & Osteopathic Physicians | Family Medicine | 207QH0002X | 9885 | NH | Y | Allopathic & Osteopathic Physicians | Family Medicine | Hospice and Palliative Medicine |
ID Information
| ID | Type | State | Issuer | Description | 2496990 | 01 | NH | CIGNA | OTHER | 0102759YPNH01 | 01 | NH | ANTHEM | OTHER | 3412774 | 01 | NH | AETNA | OTHER | 711587 | 01 | NH | HARVARD PILGRIM HLTHCARE | OTHER | 80004315 | 05 | NH | MEDICAID | 383801 | 01 | NH | MVP | OTHER |