Provider Demographics
NPI:1225150451
Name:LARGESS, CYNTHIA J
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:J
Last Name:LARGESS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:89 SUMMER ST
Mailing Address - Street 2:
Mailing Address - City:CLAREMONT
Mailing Address - State:NH
Mailing Address - Zip Code:03743-2663
Mailing Address - Country:US
Mailing Address - Phone:603-543-3948
Mailing Address - Fax:
Practice Address - Street 1:5 NURSING HOME DR
Practice Address - Street 2:
Practice Address - City:CLAREMONT
Practice Address - State:NH
Practice Address - Zip Code:03743-7344
Practice Address - Country:US
Practice Address - Phone:603-542-9511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0119225200000X
VT041-0000228225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant