Healthcare Provider Details

I. General information

NPI: 1710111265
Provider Name (Legal Business Name): HEAR-RITE HEARING CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2009
Last Update Date: 05/13/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

461 N MAIN ST
BRISTOL CT
06010-4994
US

IV. Provider business mailing address

461 N MAIN ST
BRISTOL CT
06010-4994
US

V. Phone/Fax

Practice location:
  • Phone: 860-584-5484
  • Fax: 860-584-5492
Mailing address:
  • Phone: 860-584-5484
  • Fax: 860-584-5492

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number000360
License Number StateCT

VIII. Authorized Official

Name: MR. ALYRE J ROY JR.
Title or Position: MANAGER/OWNER
Credential: BC-HIS
Phone: 860-584-5484