Healthcare Provider Details

I. General information

NPI: 1912192485
Provider Name (Legal Business Name): HEARING HEALTHCARE ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2007
Last Update Date: 09/07/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

266 CABOT ST
BEVERLY MA
01915-3370
US

IV. Provider business mailing address

266 CABOT ST P.O. BOX 488
BEVERLY MA
01915-3370
US

V. Phone/Fax

Practice location:
  • Phone: 978-922-1888
  • Fax:
Mailing address:
  • Phone: 978-922-1888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number123
License Number StateMA

VIII. Authorized Official

Name: DR. WALTER CARY LETIEN
Title or Position: AUDIOLOGIST/OWNER
Credential: AU.D.
Phone: 978-922-1888