Basic Information
Provider Information | |||||||||
NPI: | 1265694624 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | GIRAITIS | ||||||||
FirstName: | CELESTE | ||||||||
MiddleName: | JEANNINE | ||||||||
NamePrefix: | MRS. | ||||||||
NameSuffix: |   | ||||||||
Credential: | M.A., CCC-A | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: | BILODEAU | ||||||||
OtherFirstName: | CELESTE | ||||||||
OtherMiddleName: | JEANNINE | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: | 1 | ||||||||
Mailing Information | |||||||||
Address1: | 9 INDUSTRIAL RD | ||||||||
Address2: | SUITE 5 | ||||||||
City: | MILFORD | ||||||||
State: | MA | ||||||||
PostalCode: | 017573735 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 5084731480 | ||||||||
FaxNumber: | 5084731210 | ||||||||
Practice Location | |||||||||
Address1: | 42 CAPE RD | ||||||||
Address2: |   | ||||||||
City: | MILFORD | ||||||||
State: | MA | ||||||||
PostalCode: | 017573292 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 5084780555 | ||||||||
FaxNumber: | 5084735088 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 06/26/2008 | ||||||||
LastUpdateDate: | 01/07/2016 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 237600000X | 923 | MA | Y |   | Speech, Language and Hearing Service Providers | Audiologist-Hearing Aid Fitter |   |
No ID Information.