Healthcare Provider Details

I. General information

NPI: 1447682315
Provider Name (Legal Business Name): ROSEMARY CONSTANT-KAY MA HIS. #207
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/02/2013
Last Update Date: 08/02/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 EVERGREEN ST
NO DARTMOUTH MA
02747
US

IV. Provider business mailing address

25 EVERGREEN ST
NO DARTMOUTH MA
02747
US

V. Phone/Fax

Practice location:
  • Phone: 508-951-0703
  • Fax:
Mailing address:
  • Phone: 508-951-0703
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number#207
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberHAD00265
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: