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NPI Code Detail

MEDICARE: ELIZABETH J BIGELOW SPEECH PATHOLOGIST

MEDICARE: ELIZABETH J BIGELOW SPEECH PATHOLOGIST
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
1235Z00000XSpeech-Language Pathologist1914NH

General Provider Information

NPI Number : 1740816099
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH J BIGELOW SPEECH PATHOLOGIST
Provider Business Mailing Address
First Line : 806 N MAIN ST
Second Line :
City : LACONIA
State : NH
Zip : 03246-2603
Country : US
Telephone Number : 603-524-9090
Fax Number :
Provider Business Practice Location Address
First Line : 2975 DARTMOUTH COLLEGE HWY
Second Line :
City : NORTH HAVERHILL
State : NH
Zip : 03774-4535
Country : US
Telephone Number : 603-787-2113
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/19/2020
Last Update Date : 02/24/2021

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