Healthcare Provider Details

I. General information

NPI: 1306291232
Provider Name (Legal Business Name): NEW ENGLAND CENTER FOR HEARING REHABILITATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2016
Last Update Date: 03/18/2025
Certification Date: 03/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 LEDGEBROOK DR
MANSFIELD CENTER CT
06250-1664
US

IV. Provider business mailing address

33 LEDGEBROOK DR
MANSFIELD CENTER CT
06250-1664
US

V. Phone/Fax

Practice location:
  • Phone: 860-455-1404
  • Fax: 860-455-1396
Mailing address:
  • Phone: 860-455-1404
  • Fax: 860-455-1396

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number000355
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number000359
License Number StateCT
# 3
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number000355
License Number StateCT
# 4
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number000355
License Number StateCT

VIII. Authorized Official

Name: JENNIFER COX
Title or Position: CO-OWNER
Credential: AUD
Phone: 860-455-1404