Healthcare Provider Details

I. General information

NPI: 1275125239
Provider Name (Legal Business Name): AUDITORY AND VESTIBULAR INSTITUTE OF NEW ENGLAND LLC,
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2021
Last Update Date: 11/17/2025
Certification Date: 11/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3074 WHITNEY AVE BLDG 1
HAMDEN CT
06518-2391
US

IV. Provider business mailing address

21 APPLE DR
OXFORD CT
06478-3203
US

V. Phone/Fax

Practice location:
  • Phone: 475-227-0842
  • Fax: 203-745-0402
Mailing address:
  • Phone: 845-642-0367
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State

VIII. Authorized Official

Name: PAULA JENSEN
Title or Position: PRACTICE OWNER/MANAGER
Credential:
Phone: 845-642-0367