Healthcare Provider Details

I. General information

NPI: 1326182437
Provider Name (Legal Business Name): DAVID JOSEPH CIELICZKA AU.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/20/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

66 PLEASANT ST
CONCORD NH
03301-3948
US

IV. Provider business mailing address

66 PLEASANT ST.
CONCORD NH
03301
US

V. Phone/Fax

Practice location:
  • Phone: 603-224-3346
  • Fax: 603-224-2149
Mailing address:
  • Phone: 603-666-0020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberA-12
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: