Provider Demographics
NPI:1366435737
Name:CRICCO, ROBERT P (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:P
Last Name:CRICCO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:243 ELM STREET
Mailing Address - Street 2:
Mailing Address - City:CLAREMONT
Mailing Address - State:NH
Mailing Address - Zip Code:03743-2099
Mailing Address - Country:US
Mailing Address - Phone:603-542-7771
Mailing Address - Fax:603-542-3403
Practice Address - Street 1:5 DUNNING ST
Practice Address - Street 2:
Practice Address - City:CLAREMONT
Practice Address - State:NH
Practice Address - Zip Code:03743-2099
Practice Address - Country:US
Practice Address - Phone:603-542-7669
Practice Address - Fax:603-543-1323
Is Sole Proprietor?:No
Enumeration Date:2005-08-31
Last Update Date:2012-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH6007208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH0102354Y0NH01OtherBCBS
NHE72946OtherHPHC
NHGX4098Medicare PIN
NHE72946Medicare UPIN