Provider Demographics
NPI:1437229028
Name:NORTH SHORE HEARING CENTER, LLC
Entity Type:Organization
Organization Name:NORTH SHORE HEARING CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER AUDIOLOGIST
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:J
Authorized Official - Last Name:ELIA
Authorized Official - Suffix:
Authorized Official - Credentials:AUDIOLOGIST
Authorized Official - Phone:978-462-9628
Mailing Address - Street 1:24 MORRILL PL
Mailing Address - Street 2:2ND FLOOR
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:
Practice Address - Street 1:24 MORRILL PL
Practice Address - Street 2:2ND FLOOR
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:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA241W231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAVC6000170931OtherMA. REHABILITATION
MA696651OtherTUFT'S HEALTH PLAN
MA0006000010056AD002OtherCOMMISSION FOR THE BLIND
MA9727469Medicaid
MAAG0021OtherBLUE CROSS AND BLUE SHEIL
MA017166OtherNEIGHBORHOOD HEALTH PLAN
MA36257OtherHARVARD PILGRIM
MA696651OtherTUFT'S HEALTH PLAN