1033265582 NPI number — ADVANCED AUDIOLOGY ASSOCIATES, INC.

Table of content: (NPI 1033265582)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033265582 NPI number — ADVANCED AUDIOLOGY ASSOCIATES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ADVANCED AUDIOLOGY ASSOCIATES, 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:
1033265582
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/24/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
800 FALMOUTH ROAD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MASHPEE
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02649
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
508-539-9780
Provider Business Mailing Address Fax Number:
508-539-9830

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
800 FALMOUTH RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MASHPEE
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02649
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-539-9780
Provider Business Practice Location Address Fax Number:
508-539-9830
Provider Enumeration Date:
01/26/2007

Additional Information

Authorized Official

Authorized Official Last Name:
FLETCHER
Authorized Official First Name:
LEANNE
Authorized Official Middle Name:
O
Authorized Official Title or Position:
AUDIOLOGIST/CO-OWNER
Authorized Official Telephone Number:
508-539-9780

Provider Taxonomy Codes

  • Taxonomy code: 231H00000X , with the licence number:  592 TIFFANY PFLEGER , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 231H00000X , with the licence number: 543 LEANNE L ONEIL , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 807005 . This is a "TUFTS HEALTH PLAN GROUP" identifier . This identifiers is of the category "OTHER".
  • Identifier: AG0030 . This is a "BCBS GROUP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 809416 . This is a "HARVARD PILGRIM HLTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 809417 . This is a "HARVARD PILGRIM HLTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: B501031 . This is a "CIGNA HEALTHCARE GROUP" identifier . This identifiers is of the category "OTHER".




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