Provider Demographics
NPI:1255683041
Name:TIMOTHY STRINI WESTERN CT HEARING AID
Entity Type:Organization
Organization Name:TIMOTHY STRINI WESTERN CT HEARING AID
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:STRINI
Authorized Official - Suffix:
Authorized Official - Credentials:BC HIS
Authorized Official - Phone:860-489-0332
Mailing Address - Street 1:803 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:TORRINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06790-3346
Mailing Address - Country:US
Mailing Address - Phone:860-489-0332
Mailing Address - Fax:
Practice Address - Street 1:803 MAIN ST
Practice Address - Street 2:
Practice Address - City:TORRINGTON
Practice Address - State:CT
Practice Address - Zip Code:06790-3346
Practice Address - Country:US
Practice Address - Phone:860-489-0332
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-04
Last Update Date:2015-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT083332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004014957Medicaid