1104369180 NPI number — MS. JOANNE MARIE COLOMBO HUGHES MA AUDIOLOGY

Table of content: MS. JOANNE MARIE COLOMBO HUGHES MA AUDIOLOGY (NPI 1104369180)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1104369180 NPI number — MS. JOANNE MARIE COLOMBO HUGHES MA AUDIOLOGY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
COLOMBO HUGHES
Provider First Name:
JOANNE
Provider Middle Name:
MARIE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
MA AUDIOLOGY
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
COLOMBO HUGHES
Provider Other First Name:
JOANNE
Provider Other Middle Name:
MARIE
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MA AUDIOLOGY
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1104369180
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/23/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4818 S 76TH ST
Provider Second Line Business Mailing Address:
SUITE 3
Provider Business Mailing Address City Name:
GREENFIELD
Provider Business Mailing Address State Name:
WI
Provider Business Mailing Address Postal Code:
53220-4362
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
414-281-8300
Provider Business Mailing Address Fax Number:
414-455-0159

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4818 S 76TH ST
Provider Second Line Business Practice Location Address:
SUITE 3
Provider Business Practice Location Address City Name:
GREENFIELD
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
53220-4362
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
414-281-8300
Provider Business Practice Location Address Fax Number:
414-455-0159
Provider Enumeration Date:
11/23/2016

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 237600000X , with the licence number:  174-156 , registered in the state of WI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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