Provider Demographics
NPI:1093850216
Name:CHESAPEAKE HEARING CENTERS INC
Entity Type:Organization
Organization Name:CHESAPEAKE HEARING CENTERS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:PETRUZZI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-647-7795
Mailing Address - Street 1:650 RITCHIE HWY STE 104
Mailing Address - Street 2:
Mailing Address - City:SEVERNA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:21146-3910
Mailing Address - Country:US
Mailing Address - Phone:410-647-7795
Mailing Address - Fax:410-315-8823
Practice Address - Street 1:650 RITCHIE HWY STE 104
Practice Address - Street 2:
Practice Address - City:SEVERNA PARK
Practice Address - State:MD
Practice Address - Zip Code:21146-3910
Practice Address - Country:US
Practice Address - Phone:410-647-7795
Practice Address - Fax:410-315-8823
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDKW03OtherBCBS OF MD
505617OtherAETNA US HEALTHCARE
F190OtherCAREFIRST BLUE CHOICE PRE
F190OtherBLUE CROSS SHIELD FEDERAL
MDKW03OtherBCBS OF MD
MD474LMedicare PIN