Provider Demographics
NPI:1497910681
Name:PUTATURO, NICOLETTA (MA,CCC-A)
Entity Type:Individual
Prefix:
First Name:NICOLETTA
Middle Name:
Last Name:PUTATURO
Suffix:
Gender:F
Credentials:MA,CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 638269
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-8269
Mailing Address - Country:US
Mailing Address - Phone:440-816-5091
Mailing Address - Fax:
Practice Address - Street 1:15299 BAGLEY RD STE 300
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44130-4809
Practice Address - Country:US
Practice Address - Phone:440-816-5091
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-28
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHA-01066231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2085541Medicaid
OH0972309Medicaid
OHP00681444OtherMEDICARE RAILROAD PTAN
OH2085550Medicaid
OH2085550Medicaid
OHE9250486Medicare PIN
OHE9250485Medicare PIN