Provider Demographics
NPI:1265106249
Name:YERARDI, KATELYN (PT, DPT, ATC)
Entity type:Individual
Prefix:
First Name:KATELYN
Middle Name:
Last Name:YERARDI
Suffix:
Gender:F
Credentials:PT, DPT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 PORTSMOUTH AVE STE 11
Mailing Address - Street 2:
Mailing Address - City:STRATHAM
Mailing Address - State:NH
Mailing Address - Zip Code:03885-2584
Mailing Address - Country:US
Mailing Address - Phone:603-580-5919
Mailing Address - Fax:603-580-5102
Practice Address - Street 1:881 LAFAYETTE RD STE K
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:NH
Practice Address - Zip Code:03842-1242
Practice Address - Country:US
Practice Address - Phone:603-929-2880
Practice Address - Fax:603-929-1296
Is Sole Proprietor?:No
Enumeration Date:2021-08-04
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA25727225100000X
NH5121225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist