Provider Demographics
NPI:1124167036
Name:NARDELLI, CYNTHIA (MS,CCC-A)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:NARDELLI
Suffix:
Gender:F
Credentials:MS,CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 ROSEBUD PLZ
Mailing Address - Street 2:
Mailing Address - City:CLARKSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26301-9386
Mailing Address - Country:US
Mailing Address - Phone:304-622-1837
Mailing Address - Fax:304-326-3430
Practice Address - Street 1:620 ROSEBUD PLZ
Practice Address - Street 2:
Practice Address - City:CLARKSBURG
Practice Address - State:WV
Practice Address - Zip Code:26301-9386
Practice Address - Country:US
Practice Address - Phone:304-622-1837
Practice Address - Fax:304-326-3430
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2011-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVA-0059237600000X, 231HA2400X, 231HA2500X, 231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
No231HA2400XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Practitioner
No231HA2500XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0160433000Medicaid
WVBA0709271Medicare ID - Type Unspecified