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General NPI Number Information
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NPI Number | 1538485727
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Entity Type | Organization
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Legal Business Name | MOBILE MEDICAL AUDIOLOGY MA LLC
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Dates
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Enumeration Date | 04/13/2010
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Last Update Date | 02/25/2019
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Provider Practice Location Address
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Address Line | 92 HIGH ST STE 23
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City | MEDFORD
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State | MA
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Zip | 02155-3850
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Country | US
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Telephone | 617-947-0615
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Fax | 781-723-4691
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Provider Business Mailing Address
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Address Line | 92 HIGH ST STE 23
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City | MEDFORD
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State | MA
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Zip | 02155-3850
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Country | US
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Telephone | 617-947-0615
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Fax | 781-723-4691
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Authorized Official
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Title or Position | OWNER
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Name | LOUIS ANTHONY FEMINO
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Credential | CCC-A
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Telephone | 617-947-0615
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number |
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License Number State |
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