Provider Demographics
NPI:1659924728
Name:CAIAZZO, CHRIS ANDREW (LMT)
Entity Type:Individual
Prefix:
First Name:CHRIS
Middle Name:ANDREW
Last Name:CAIAZZO
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 1/2 CHARBONNEAU ST
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:NH
Mailing Address - Zip Code:03051-4851
Mailing Address - Country:US
Mailing Address - Phone:978-852-8371
Mailing Address - Fax:
Practice Address - Street 1:783 ROUTE 3A
Practice Address - Street 2:
Practice Address - City:BOW
Practice Address - State:NH
Practice Address - Zip Code:03304-4045
Practice Address - Country:US
Practice Address - Phone:603-228-7711
Practice Address - Fax:603-228-7701
Is Sole Proprietor?:No
Enumeration Date:2019-07-18
Last Update Date:2019-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH3418225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist