Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 22377 | NH |
N | 207YX0007X | Plastic Surgeon (Head & Neck) | 22377 | NH |
N | 207YX0007X | Plastic Surgeon (Head & Neck) | A149372 | CA |
NPI | 1063778363 |
---|---|
Provider Name | Dr. Carly Jiganti Schrage |
First Address | Laconia, NH 03246-3113 |
Second Address | Laconia, NH 03246-3113 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2012 |
Last Update Date | 09/02/2022 |