1386869006 NPI number — DR. PAMELA KIM PARENTE AU.D., CCC-A, FAAA

Table of content: DR. PAMELA KIM PARENTE AU.D., CCC-A, FAAA (NPI 1386869006)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386869006 NPI number — DR. PAMELA KIM PARENTE AU.D., CCC-A, FAAA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PARENTE
Provider First Name:
PAMELA
Provider Middle Name:
KIM
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
AU.D., CCC-A, FAAA
Provider Gender Code:
F

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:
1386869006
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/11/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PROFESSIONAL HEARING SERVICES, LLC
Provider Second Line Business Mailing Address:
27 PRIMROSE STREET
Provider Business Mailing Address City Name:
NORTH HAVEN
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06473-2934
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
203-281-1212
Provider Business Mailing Address Fax Number:
203-281-2746

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
PROFESSIONAL HEARING SERVICES, LLC
Provider Second Line Business Practice Location Address:
27 PRIMROSE STREET
Provider Business Practice Location Address City Name:
NORTH HAVEN
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06473-2934
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-281-1212
Provider Business Practice Location Address Fax Number:
203-281-2746
Provider Enumeration Date:
04/16/2007

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: 231H00000X , with the licence number:  000392 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 231H00000X , with the licence number: AUD00031 , registered in the state of RI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 730000392CT01 . This is a "ANTHEMBCBSPROVIDER NUMBER" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".