=====================================================
General NPI Number Information
=====================================================
NPI Number | 1366209660
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HEARING CENTER OF NEW HAMPSHIRE, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/04/2024
-----------------------------------------------------
Last Update Date | 07/30/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 14 TSIENNETO RD # 305A
-----------------------------------------------------
City | DERRY
-----------------------------------------------------
State | NH
-----------------------------------------------------
Zip | 03038-1647
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 603-669-0831
-----------------------------------------------------
Fax | 603-541-4898
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 288 S RIVER RD BLDG A1
-----------------------------------------------------
City | BEDFORD
-----------------------------------------------------
State | NH
-----------------------------------------------------
Zip | 03110-7089
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 603-595-4800
-----------------------------------------------------
Fax | 603-541-4898
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANAGER
-----------------------------------------------------
Name | DR. EMMA B MICHAUD
-----------------------------------------------------
Credential | AUD
-----------------------------------------------------
Telephone | 603-595-4800
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QH0700X
-----------------------------------------------------
Taxonomy Name | Hearing and Speech Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------