Healthcare Provider Details

I. General information

NPI: 1689863102
Provider Name (Legal Business Name): MOBILE AUDIOLOGY ASSOCIATES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/22/2007
Last Update Date: 12/31/2019
Certification Date: 12/31/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 CROSSING BLVD SUITE 300
FRAMINGHAM MA
01702-5555
US

IV. Provider business mailing address

100 CROSSING BLVD SUITE 300
FRAMINGHAM MA
01702-5555
US

V. Phone/Fax

Practice location:
  • Phone: 617-964-6681
  • Fax: 339-686-2561
Mailing address:
  • Phone: 617-964-6681
  • Fax: 339-686-2561

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. LAURA L. TASSE
Title or Position: OWNER/PRESIDENT
Credential: AUD
Phone: 617-964-6681