Provider Demographics
NPI:1093974073
Name:SPEECH-LANGUAGE AND HEARING ASSOCIATES OF GREATER BOSTON, PC
Entity Type:Organization
Organization Name:SPEECH-LANGUAGE AND HEARING ASSOCIATES OF GREATER BOSTON, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MAURA
Authorized Official - Middle Name:G
Authorized Official - Last Name:MARKS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD CCC-A SLP
Authorized Official - Phone:508-359-4532
Mailing Address - Street 1:5 NORTH MEADOWS RD
Mailing Address - Street 2:SPEECH-LANGUAGE &HEARING ASSOCIATES OF GREATER BOSTON
Mailing Address - City:MEDFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:02052-2317
Mailing Address - Country:US
Mailing Address - Phone:508-359-4532
Mailing Address - Fax:508-359-0198
Practice Address - Street 1:5 NORTH MEADOWS RD
Practice Address - Street 2:SPEECH-LANGUAGE & HEARING ASSOCIATES OF GREATER BOSTON
Practice Address - City:MEDFIELD
Practice Address - State:MA
Practice Address - Zip Code:02052-2317
Practice Address - Country:US
Practice Address - Phone:508-359-4532
Practice Address - Fax:508-359-0198
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-05
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA620733OtherTUFTS
MA1093974073OtherNPI
MA1942270574Medicaid
MA626538OtherHARVARD PILGRIM
MA3668706OtherAETNA
MAAD158OtherBLUE CROSS-AUDIOLOGIST
MA1093974073Medicaid
MAAG0032OtherBLUE CROSS BLUE SHIELD
MA1326437609OtherNPI
MA1326437609Medicaid
MA226538OtherMEDICARE A
MASL-M21875OtherMEDICARE B
MA1942270574OtherNPI
MAAD0194OtherBLUE CROSS- AUDIOLOGIST