Healthcare Provider Details

I. General information

NPI: 1144376260
Provider Name (Legal Business Name): CAROLYN HUSSEY GAIERO AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CAROLYN RUTH HUSSEY

II. Dates (important events)

Enumeration Date: 01/25/2007
Last Update Date: 05/11/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

147 NORTHPORT AVE
BELFAST ME
04915
US

IV. Provider business mailing address

147 NORTHPORT AVE
BELFAST ME
04915
US

V. Phone/Fax

Practice location:
  • Phone: 207-338-6770
  • Fax: 207-338-3488
Mailing address:
  • Phone: 207-338-6770
  • Fax: 207-338-3488

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAP1107
License Number StateME
# 2
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License NumberDL350
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: