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NPI Code Detail

MEDICARE: ALICE M BASSEN AU.D CCC/A

MEDICARE:   ALICE M BASSEN  AU.D CCC/A
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1237600000XAudiologist-Hearing Aid Fitter321MA
2231H00000XAudiologist321MA

General Provider Information

NPI Number : 1649825753
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALICE M BASSEN AU.D CCC/A
Provider Business Mailing Address
First Line : 725 NORTH ST
Second Line :
City : PITTSFIELD
State : MA
Zip : 01201-4124
Country : US
Telephone Number : 413-447-2225
Fax Number : 413-346-6798
Provider Business Practice Location Address
First Line : 510 NORTH ST STE 6
Second Line :
City : PITTSFIELD
State : MA
Zip : 01201-4117
Country : US
Telephone Number : 413-447-2225
Fax Number : 413-346-6798
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/06/2019
Last Update Date : 08/06/2019

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Directions to “ ALICE M BASSEN AU.D CCC/A” Practice Location

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