Healthcare Provider Details

I. General information

NPI: 1154610012
Provider Name (Legal Business Name): CYNTHIA WEINBERGER, OT/L, CHT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2011
Last Update Date: 03/31/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

53 MAPLE STREET
SUNAPEE NH
03782-0841
US

IV. Provider business mailing address

PO BOX 841
SUNAPEE NH
03782-0841
US

V. Phone/Fax

Practice location:
  • Phone: 603-504-5030
  • Fax:
Mailing address:
  • Phone: 603-504-5030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number0728
License Number StateNH

VIII. Authorized Official

Name: CYNTHIA CARRON WEINBERGER
Title or Position: OWNER
Credential: OT/L, CHT
Phone: 603-504-5030