Provider Demographics
NPI:1598849697
Name:ROSTRON, SUSAN HANNAH (AUD)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:HANNAH
Last Name:ROSTRON
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 STANFORD DR
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06032-2454
Mailing Address - Country:US
Mailing Address - Phone:860-640-4455
Mailing Address - Fax:860-640-4478
Practice Address - Street 1:40 STANFORD DR
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:CT
Practice Address - Zip Code:06032-2454
Practice Address - Country:US
Practice Address - Phone:860-640-4455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2023-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT00433231H00000X
CT000433237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter