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General NPI Number Information
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NPI Number | 1609373588
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Entity Type | Organization
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Legal Business Name | SACRED HEART UNIVERSITY
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Dates
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Enumeration Date | 04/09/2018
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Last Update Date | 09/28/2018
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Provider Practice Location Address
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Address Line | 4000 PARK AVE
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City | BRIDGEPORT
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State | CT
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Zip | 06604-1047
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Country | US
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Telephone | 203-396-6895
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Fax |
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Provider Business Mailing Address
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Address Line | 5151 PARK AVE
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City | FAIRFIELD
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State | CT
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Zip | 06825-1090
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | AUDIOLOGIST/CLINICAL ASSISTANT PROF
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Name | JAMIE MAROTTO
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Credential | AUD
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Telephone | 203-644-2865
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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 | 552
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License Number State | CT
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