Provider Demographics
NPI:1659322238
Name:CADORETTE, TERESA MARY (MD)
Entity Type:Individual
Prefix:DR
First Name:TERESA
Middle Name:MARY
Last Name:CADORETTE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 MAIN ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:PETERBOROUGH
Mailing Address - State:NH
Mailing Address - Zip Code:03458-2433
Mailing Address - Country:US
Mailing Address - Phone:603-924-0804
Mailing Address - Fax:603-924-0844
Practice Address - Street 1:45 MAIN ST
Practice Address - Street 2:SUITE 101
Practice Address - City:PETERBOROUGH
Practice Address - State:NH
Practice Address - Zip Code:03458-2433
Practice Address - Country:US
Practice Address - Phone:603-924-0804
Practice Address - Fax:603-924-0844
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2009-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH91832084P0800X
TXH42022084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
1336393552OtherNPI, ORGANIZATIONAL
1659322238OtherNPI, INDIVIDUAL
1659322238OtherNPI, INDIVIDUAL
RE310902Medicare PIN