Healthcare Provider Details

I. General information

NPI: 1790164929
Provider Name (Legal Business Name): COMPREHENSIVE HEARING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2015
Last Update Date: 05/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

415 HIGHLAND AVE
CHESHIRE CT
06410-2555
US

IV. Provider business mailing address

415 HIGHLAND AVE
CHESHIRE CT
06410-2555
US

V. Phone/Fax

Practice location:
  • Phone: 203-272-4512
  • Fax: 203-272-4517
Mailing address:
  • Phone: 203-272-4512
  • Fax: 203-272-4517

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number314
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number314
License Number StateCT

VIII. Authorized Official

Name: DR. JENNIFER DEMPSEY WALLBERG
Title or Position: DOCTOR OF AUDIOLOGY/OWNER
Credential: AU.D.
Phone: 203-272-4512