Healthcare Provider Details

I. General information

NPI: 1568844033
Provider Name (Legal Business Name): JAMIE G LOSCHEN AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2015
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 MARINERS WAY
EDGARTOWN MA
02539
US

IV. Provider business mailing address

PO BOX 945
EDGARTOWN MA
02539-0945
US

V. Phone/Fax

Practice location:
  • Phone: 508-627-0565
  • Fax: 508-627-0565
Mailing address:
  • Phone: 508-627-0565
  • Fax: 508-290-9533

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number1070
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number1070
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: