Provider Demographics
NPI:1265473029
Name:ELIA, CHARLES J (MA)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:J
Last Name:ELIA
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:24 MORRILL PL
Mailing Address - Street 2:
Mailing Address - City:AMESBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01913-3530
Mailing Address - Country:US
Mailing Address - Phone:978-462-9628
Mailing Address - Fax:978-834-0101
Practice Address - Street 1:24 MORRILL PL
Practice Address - Street 2:
Practice Address - City:AMESBURY
Practice Address - State:MA
Practice Address - Zip Code:01913-3530
Practice Address - Country:US
Practice Address - Phone:978-462-9628
Practice Address - Fax:978-834-0101
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA241W237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAAD0147OtherBLUE CROSS /BLUE SHEILD
MA36257OtherHARVARD PLIGRIM
MA0017846OtherNEIGHBORHOOD HEALTH PLAN
MAAD0147OtherBLUE CROSS/BLUE SHEILD
MA5104459Medicaid
MA696651OtherTUFT'S HEALTH PLAN
MA5104459Medicaid
MA029864Medicare ID - Type Unspecified