Provider Demographics
NPI:1275083289
Name:COASTAL HEARING CLINIC, INC.
Entity Type:Organization
Organization Name:COASTAL HEARING CLINIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHERI
Authorized Official - Middle Name:
Authorized Official - Last Name:MAGNACCA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:774-413-5023
Mailing Address - Street 1:45 TOPSFIELD CIR
Mailing Address - Street 2:
Mailing Address - City:SHREWSBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01545-3913
Mailing Address - Country:US
Mailing Address - Phone:508-868-2315
Mailing Address - Fax:
Practice Address - Street 1:33 JARVES ST
Practice Address - Street 2:
Practice Address - City:SANDWICH
Practice Address - State:MA
Practice Address - Zip Code:02563-2041
Practice Address - Country:US
Practice Address - Phone:774-413-9431
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-13
Last Update Date:2016-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA100237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty