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NPI Code Detail

MEDICARE: TERRI LOEWENTHAL CCC-A

MEDICARE: TERRI LOEWENTHAL CCC-A
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
1231H00000XAudiologist129MA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1AD0067OTHERBS BLUECARE ELECT
25102855OTHERMASS HEALTH
363412OTHERCHILDRENS MEDICAL SECURIT
4AD0067OTHERBLUE SHIELD INDEMNITY
5AD0067OTHERHMO BLUE/BLUE CHOICE

General Provider Information

NPI Number : 1659378289
Entity Type Code : Individual
Provider Name (Legal Business Name) : TERRI LOEWENTHAL CCC-A
Provider Business Mailing Address
First Line : PO BOX 9120
Second Line :
City : DEDHAM
State : MA
Zip : 02027-9120
Country : US
Telephone Number : 781-329-1400
Fax Number : 781-278-5667
Provider Business Practice Location Address
First Line : 1 LYONS ST
Second Line :
City : DEDHAM
State : MA
Zip : 02026-5599
Country : US
Telephone Number : 781-329-1400
Fax Number : 781-278-5667
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/28/2005
Last Update Date : 07/08/2007

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1811993447 — MICHAEL FERRIS MD
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1609872233 — R MATTHEW MINER D.D.S.
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Directions to “ TERRI LOEWENTHAL CCC-A” Practice Location

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