Provider Demographics
NPI:1073271318
Name:MAST AUDIOLOGY SERVICES, LLC
Entity Type:Organization
Organization Name:MAST AUDIOLOGY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGIST, OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHEKINAH
Authorized Official - Middle Name:
Authorized Official - Last Name:MAST
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:302-943-5807
Mailing Address - Street 1:808 MIDDLEFORD RD STE 4
Mailing Address - Street 2:
Mailing Address - City:SEAFORD
Mailing Address - State:DE
Mailing Address - Zip Code:19973-3650
Mailing Address - Country:US
Mailing Address - Phone:302-404-5084
Mailing Address - Fax:302-404-5269
Practice Address - Street 1:808 MIDDLEFORD RD STE 4
Practice Address - Street 2:
Practice Address - City:SEAFORD
Practice Address - State:DE
Practice Address - Zip Code:19973-3650
Practice Address - Country:US
Practice Address - Phone:302-404-5084
Practice Address - Fax:302-404-5269
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-03
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty