Provider Demographics
NPI:1952548810
Name:LAGATTUTA, DAVID JAMES (MA)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:JAMES
Last Name:LAGATTUTA
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 GLENDALE RD
Mailing Address - Street 2:UNIT A-10
Mailing Address - City:HAVERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19083-3152
Mailing Address - Country:US
Mailing Address - Phone:610-449-2495
Mailing Address - Fax:
Practice Address - Street 1:400 GLENDALE RD
Practice Address - Street 2:UNIT A-10
Practice Address - City:HAVERTOWN
Practice Address - State:PA
Practice Address - Zip Code:19083-3152
Practice Address - Country:US
Practice Address - Phone:610-449-2495
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-14
Last Update Date:2009-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAATOO1113L231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist