1528573086 NPI number — NEW ENGLAND HEARING ALLIANCE, INC.

Table of content: THOMAS ALAN BANTON O.D. (NPI 1720126469)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528573086 NPI number — NEW ENGLAND HEARING ALLIANCE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NEW ENGLAND HEARING ALLIANCE, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1528573086
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/06/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
775 HEATH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHESTNUT HILL
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02467-2666
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
617-935-6572
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2000 WASHINGTON STREET
Provider Second Line Business Practice Location Address:
MOB WHITE 544
Provider Business Practice Location Address City Name:
NEWTON
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02462
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
617-910-0368
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/06/2017

Additional Information

Authorized Official

Authorized Official Last Name:
KORDA
Authorized Official First Name:
ANDREW
Authorized Official Middle Name:
MILLER
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
617-935-6572

Provider Taxonomy Codes

  • Taxonomy code: 237600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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