Healthcare Provider Details

I. General information

NPI: 1871898726
Provider Name (Legal Business Name): DIAGNOSTIC HEARING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2011
Last Update Date: 01/24/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

92 HIGH STREET SUITE 23
MEDFORD MA
02155
US

IV. Provider business mailing address

92 HIGH STREET SUITE 23
MEDFORD MA
02155
US

V. Phone/Fax

Practice location:
  • Phone: 781-820-1217
  • Fax:
Mailing address:
  • Phone: 781-820-1217
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. LOU FEMINO
Title or Position: PRESIDENT
Credential: AUD
Phone: 781-820-1217