Healthcare Provider Details

I. General information

NPI: 1437312212
Provider Name (Legal Business Name): ATLANTIC HEARING CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2008
Last Update Date: 08/27/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1150 RESERVOIR AVE STE. 305B
CRANSTON RI
02920-6068
US

IV. Provider business mailing address

1150 RESERVOIR AVE STE. 305B
CRANSTON RI
02920-6068
US

V. Phone/Fax

Practice location:
  • Phone: 401-942-8080
  • Fax: 401-942-3666
Mailing address:
  • Phone: 401-942-8080
  • Fax: 401-942-3666

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAUD00042
License Number StateRI

VIII. Authorized Official

Name: GEORGE R GEEHAN
Title or Position: OWNER
Credential: MS
Phone: 401-942-8080