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General NPI Number Information
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NPI Number | 1083744320
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Entity Type | Individual
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Provider Name | JESSICA J VANDERFEEN AU.D., CCC-A
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Gender | Female
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 06/27/2025
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Provider Practice Location Address
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Address Line | 440 N MAIN ST STE C
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City | BRISTOL
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State | CT
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Zip | 06010
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Country | US
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Telephone | 860-893-1977
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Fax | 860-845-5330
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Provider Business Mailing Address
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Address Line | 440 N MAIN ST STE C
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City | BRISTOL
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State | CT
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Zip | 06010
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Country | US
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Telephone | 860-570-2318
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Fax | 860-570-2271
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 237600000X
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Taxonomy Name | Audiologist-Hearing Aid Fitter
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 000351
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License Number State | CT
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