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General NPI Number Information
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NPI Number | 1114171840
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Entity Type | Individual
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Provider Name | SUGATA BHATTACHARJEE AUD
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Gender | Male
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Dates
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Enumeration Date | 11/07/2008
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Last Update Date | 06/03/2011
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Provider Practice Location Address
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Address Line | 61 LAWRENCE RD
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City | DERRY
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State | NH
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Zip | 03038-4190
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Country | US
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Telephone | 703-380-2867
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Fax |
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Provider Business Mailing Address
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Address Line | 61 LAWRENCE RD
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City | DERRY
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State | NH
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Zip | 03038-4190
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Country | US
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Telephone | 703-380-2867
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 237600000X
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Taxonomy Name | Audiologist-Hearing Aid Fitter
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License Number | A555
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License Number State | NH
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Taxonomy #2
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | SP891AU
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License Number State | MA
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