MEDICARE: CYNTHIA FURNBACH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	0045	NH

General Provider Information

NPI Number	:	1366695165
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CYNTHIA FURNBACH

Provider Business Mailing Address
First Line	:	20 KIDDER DR.
Second Line	:
City	:	FREEDOM
State	:	NH
Zip	:	03836
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	20 KIDDER DR.
Second Line	:
City	:	FREEDOM
State	:	NH
Zip	:	03836
Country	:	US
Telephone Number	:	603-539-6117
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/24/2008
Last Update Date	:	04/30/2009

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Directions to “ CYNTHIA FURNBACH ” Practice Location

Language	Start Address	Practice Location

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