Provider Demographics
NPI:1467783647
Name:BARTLETT, ILDIKO FARKAS (LMT)
Entity Type:Individual
Prefix:MS
First Name:ILDIKO
Middle Name:FARKAS
Last Name:BARTLETT
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:MS
Other - First Name:ILDIKO
Other - Middle Name:FARKAS
Other - Last Name:INGRAHAM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMT
Mailing Address - Street 1:308 WILTON RD
Mailing Address - Street 2:
Mailing Address - City:PETERBOROUGH
Mailing Address - State:NH
Mailing Address - Zip Code:03458-1913
Mailing Address - Country:US
Mailing Address - Phone:603-554-7799
Mailing Address - Fax:
Practice Address - Street 1:308 WILTON RD
Practice Address - Street 2:
Practice Address - City:PETERBOROUGH
Practice Address - State:NH
Practice Address - Zip Code:03458-1913
Practice Address - Country:US
Practice Address - Phone:603-554-7799
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-27
Last Update Date:2010-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2660M225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist