Provider Demographics
NPI:1306205323
Name:AYZENBERG, NATALIYA V (AUD, PHD)
Entity Type:Individual
Prefix:DR
First Name:NATALIYA
Middle Name:V
Last Name:AYZENBERG
Suffix:
Gender:F
Credentials:AUD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 WARREN AVE
Mailing Address - Street 2:
Mailing Address - City:WOBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01801-7906
Mailing Address - Country:US
Mailing Address - Phone:781-573-3277
Mailing Address - Fax:781-933-0478
Practice Address - Street 1:23 WARREN AVE
Practice Address - Street 2:
Practice Address - City:WOBURN
Practice Address - State:MA
Practice Address - Zip Code:01801-7906
Practice Address - Country:US
Practice Address - Phone:781-573-3277
Practice Address - Fax:781-933-0478
Is Sole Proprietor?:No
Enumeration Date:2016-02-18
Last Update Date:2019-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1079237600000X
NHA665237600000X, 231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3076955Medicaid
NH23059Medicare PIN