Physician Compare National (NPI:1417934142)

HEALTHCARE PROVIDER: CARYN A LIBBEY M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1417934142
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	9537329180
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20180924002195
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	LIBBEY
	Individual professional last name
Provider First Name	CARYN
	Individual professional first name
Provider Middle Name	A
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	TUFTS UNIVERSITY SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1975
	Individual professional's medical school graduation year
Primary Specialty	RHEUMATOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	19 TYLER ST
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 205
	Group Practice or individual's line 2 address
City	NASHUA
	Group Practice or individual's city
State	NH
	Group Practice or individual's state
Zip Code	030602951
	Group Practice or individual's zip code (9 digits when available)
Phone Number	6038895690
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	300011
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	ST JOSEPH HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	220031
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	BOSTON MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	300020
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	SOUTHERN NH MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	300003
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	MARY HITCHCOCK MEMORIAL HOSPITAL
	Legal business name of hospital where individual professional provides service 4
Professional Accepts Medicare Assignment	Y