Healthcare Provider Details

I. General information

NPI: 1528162971
Provider Name (Legal Business Name): SMITH HEARING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99 CAMP MOWEEN RD
LEBANON CT
06249-2704
US

IV. Provider business mailing address

99 CAMP MOWEEN ROAD
LEBANON CT
06249
US

V. Phone/Fax

Practice location:
  • Phone: 869-885-6166
  • Fax: 869-859-0824
Mailing address:
  • Phone: 869-885-6166
  • Fax: 869-859-0824

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number000378
License Number StateCT

VIII. Authorized Official

Name: MR. BRUCE E. SMITH
Title or Position: OWNER
Credential:
Phone: 860-885-6166