Healthcare Provider Details

I. General information

NPI: 1871688291
Provider Name (Legal Business Name): CAROLE MARIE DIPARDO PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CAROLE MARIE MARQUIS PA-C

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 08/11/2022
Certification Date: 08/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

246 PLEASANT ST. MEMORIAL BUILDING, WEST, GROUND FLOOR
CONCORD NH
03301-0330
US

IV. Provider business mailing address

246 PLEASANT ST. MEMORIAL BUILDING, WEST, GROUND FLOOR
CONCORD NH
03301-2548
US

V. Phone/Fax

Practice location:
  • Phone: 603-224-1725
  • Fax: 603-227-7557
Mailing address:
  • Phone: 603-224-1725
  • Fax: 603-227-7557

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number1072
License Number StateNH
# 2
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number1072
License Number StateNH
# 3
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number1072
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: