MEDICARE: CARON C. WEINER MS/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
1	231H00000X	Audiologist	319	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1912947813
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARON C. WEINER MS/CCC-A

Provider Business Mailing Address
First Line	:	725 CONCORD AVE
Second Line	:	SUITE 2300
City	:	CAMBRIDGE
State	:	MA
Zip	:	02138-1040
Country	:	US
Telephone Number	:	617-499-3353
Fax Number	:	617-499-3354

Provider Business Practice Location Address
First Line	:	725 CONCORD AVE
Second Line	:	SUITE 2300
City	:	CAMBRIDGE
State	:	MA
Zip	:	02138-1040
Country	:	US
Telephone Number	:	617-499-3353
Fax Number	:	617-499-3354

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/08/2006
Last Update Date	:	07/09/2007

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