MEDICARE: MR. ALEX LEE HIS

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	237700000X	Hearing Instrument Specialist	311	MA

General Provider Information

NPI Number	:	1922465699
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ALEX LEE HIS

Provider Business Mailing Address
First Line	:	33 LYMAN ST STE 103A
Second Line	:
City	:	WESTBOROUGH
State	:	MA
Zip	:	01581-5403
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	33 LYMAN ST STE 103A
Second Line	:
City	:	WESTBOROUGH
State	:	MA
Zip	:	01581-5403
Country	:	US
Telephone Number	:	508-366-8686
Fax Number	:

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

Provider Enumeration Date	:	01/26/2016
Last Update Date	:	01/26/2016

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