MEDICARE: ANDREA M. SIMONSON PHD, 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
1	231H00000X	Audiologist	606	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	AA143253	OTHER	MA	HARVARD PILGRIM HEALTHCARE
3	097372	OTHER	MA	TUFTS
4	AD0206	OTHER	MA	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1841469624
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREA M. SIMONSON PHD, CCC-A

Provider Business Mailing Address
First Line	:	560 HILLSIDE AVE
Second Line	:
City	:	NEEDHAM
State	:	MA
Zip	:	02494-1232
Country	:	US
Telephone Number	:	617-524-3864
Fax Number	:

Provider Business Practice Location Address
First Line	:	560 HILLSIDE AVE
Second Line	:
City	:	NEEDHAM
State	:	MA
Zip	:	02494-1232
Country	:	US
Telephone Number	:	617-524-3864
Fax Number	:

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

Provider Enumeration Date	:	02/26/2008
Last Update Date	:	09/25/2015

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