Provider Demographics
NPI:1750552527
Name:CESATI, LAURIE M (M ED)
Entity type:Individual
Prefix:
First Name:LAURIE
Middle Name:M
Last Name:CESATI
Suffix:
Gender:F
Credentials:M ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 CANTON ST STE 2
Mailing Address - Street 2:DARTMOUTH-HITCHCOCK CLINIC - AUDIOLOGY
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03103-3524
Mailing Address - Country:US
Mailing Address - Phone:603-622-3623
Mailing Address - Fax:
Practice Address - Street 1:30 CANTON ST STE 2
Practice Address - Street 2:DARTMOUTH-HITCHCOCK CLINIC - AUDIOLOGY
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03103-3524
Practice Address - Country:US
Practice Address - Phone:603-622-3623
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-19
Last Update Date:2015-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHA545231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
020404925OtherTIN