Healthcare Provider Details

I. General information

NPI: 1508621400
Provider Name (Legal Business Name): MADELINE M CICATELLI MS OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/19/2024
Last Update Date: 02/19/2024
Certification Date: 02/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

777 LAFAYETTE RD
HAMPTON NH
03842-1254
US

IV. Provider business mailing address

713 TRI CITY RD
SOMERSWORTH NH
03878-1336
US

V. Phone/Fax

Practice location:
  • Phone: 603-929-3032
  • Fax:
Mailing address:
  • Phone: 617-272-6659
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number3075
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: