MEDICARE: DR. TAYLOR CHABOT 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	4770	MA

General Provider Information

NPI Number	:	1578123592
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TAYLOR CHABOT AUD

Provider Business Mailing Address
First Line	:	990 PARADISE RD STE 3A
Second Line	:
City	:	SWAMPSCOTT
State	:	MA
Zip	:	01907-1309
Country	:	US
Telephone Number	:	781-581-1500
Fax Number	:

Provider Business Practice Location Address
First Line	:	990 PARADISE RD STE 3A
Second Line	:
City	:	SWAMPSCOTT
State	:	MA
Zip	:	01907-1309
Country	:	US
Telephone Number	:	781-581-1500
Fax Number	:

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

Provider Enumeration Date	:	06/20/2019
Last Update Date	:	04/17/2020

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