MEDICARE: PAULA FISHER CALHOUN AUD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	231H00000X	Audiologist	000465	CT

General Provider Information

NPI Number	:	1275652281
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAULA FISHER CALHOUN AUD

Provider Business Mailing Address
First Line	:	263 FARMINGTON AVE
Second Line	:
City	:	FARMINGTON
State	:	CT
Zip	:	06030-8082
Country	:	US
Telephone Number	:	860-679-2804
Fax Number	:	860-679-1179

Provider Business Practice Location Address
First Line	:	31 BROADWAY
Second Line	:
City	:	NORTH HAVEN
State	:	CT
Zip	:	06473-2363
Country	:	US
Telephone Number	:	203-234-1324
Fax Number	:	203-234-1611

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/29/2007
Last Update Date	:	11/18/2022

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