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General NPI Number Information
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NPI Number | 1639822182
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Entity Type | Organization
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Legal Business Name | VINEYARD AUDIOLOGY
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Dates
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Enumeration Date | 02/03/2022
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Last Update Date | 09/28/2022
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Provider Practice Location Address
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Address Line | 20 INDIAN HILL ROAD
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City | W. TISBURY
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State | MA
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Zip | 02575
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Country | US
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Telephone | 508-696-4600
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2095
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City | VINEYARD HAVEN
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State | MA
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Zip | 02568-0915
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Country | US
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Telephone | 508-696-4600
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Fax |
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Authorized Official
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Title or Position | AUDIOLOGIST
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Name | DR. LESLEY SEGAL
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Credential | AUD
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Telephone | 508-696-4600
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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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