1477721439 NPI number — MRS. SUSAN GIUDITTA SHEEHY RD LD

Table of content: MRS. SUSAN GIUDITTA SHEEHY RD LD (NPI 1477721439)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477721439 NPI number — MRS. SUSAN GIUDITTA SHEEHY RD LD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SHEEHY
Provider First Name:
SUSAN
Provider Middle Name:
GIUDITTA
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
RD LD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
GIUDITTA
Provider Other First Name:
SUSAN
Provider Other Middle Name:
ELISE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1477721439
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/13/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
100 MCGREGOR ST
Provider Second Line Business Mailing Address:
CATHOLIC MEDICAL CENTER
Provider Business Mailing Address City Name:
MANCHESTER
Provider Business Mailing Address State Name:
NH
Provider Business Mailing Address Postal Code:
03102
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
603-663-6211
Provider Business Mailing Address Fax Number:
603-663-6663

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
100 MCGREGOR ST
Provider Second Line Business Practice Location Address:
CHOLESTEROL MANAGEMENT CENTER
Provider Business Practice Location Address City Name:
MANCHESTER
Provider Business Practice Location Address State Name:
NH
Provider Business Practice Location Address Postal Code:
03102
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
603-663-6211
Provider Business Practice Location Address Fax Number:
603-663-6663
Provider Enumeration Date:
02/13/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 133V00000X , with the licence number:  RD720998 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 133V00000X , with the licence number: LD41 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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