Healthcare Provider Details

I. General information

NPI: 1710542402
Provider Name (Legal Business Name): DIAGNOSTIC HEARING INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2019
Last Update Date: 04/07/2020
Certification Date: 04/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

92 HIGH ST STE 23
MEDFORD MA
02155-3850
US

IV. Provider business mailing address

92 HIGH ST STE 23
MEDFORD MA
02155-3850
US

V. Phone/Fax

Practice location:
  • Phone: 617-947-0615
  • Fax: 781-723-4691
Mailing address:
  • Phone: 508-837-3790
  • Fax: 781-723-4691

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State

VIII. Authorized Official

Name: LOUIS A FEMINO
Title or Position: OWNER
Credential: AUD
Phone: 508-837-3790