=====================================================
General NPI Number Information
=====================================================
NPI Number | 1821421942
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NP SKINCARE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/12/2013
-----------------------------------------------------
Last Update Date | 08/18/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 39 NEW LONDON TPKE STE 218
-----------------------------------------------------
City | GLASTONBURY
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06033-4208
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 860-999-1062
-----------------------------------------------------
Fax | 877-915-7942
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 31 MAGNOLIA DR
-----------------------------------------------------
City | SUFFIELD
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06078-1551
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 860-324-0844
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MS. LENORE S CROSSON
-----------------------------------------------------
Credential | NP
-----------------------------------------------------
Telephone | 860-324-0844
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174400000X
-----------------------------------------------------
Taxonomy Name | Specialist
-----------------------------------------------------
License Number | 002480
-----------------------------------------------------
License Number State | CT
-----------------------------------------------------