Provider Demographics
NPI:1518160985
Name:DALTERIO, MARIA
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:DALTERIO
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 1:86 ROCKINGHAM ST
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-2652
Mailing Address - Country:US
Mailing Address - Phone:603-226-4847
Mailing Address - Fax:
Practice Address - Street 1:57 SCHOOL ST
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-3930
Practice Address - Country:US
Practice Address - Phone:603-229-1789
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH9321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30420723Medicaid
NH30420723Medicaid