Provider Demographics
NPI:1497950323
Name:PROFESSIONAL HEARING SERVICES, LLC
Entity Type:Organization
Organization Name:PROFESSIONAL HEARING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF AUDIOLOGY
Authorized Official - Prefix:DR
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:KIM
Authorized Official - Last Name:PARENTE
Authorized Official - Suffix:
Authorized Official - Credentials:AUD, CCC-A, F-AAA
Authorized Official - Phone:203-288-1212
Mailing Address - Street 1:27 PRIMROSE ST
Mailing Address - Street 2:
Mailing Address - City:NORTH HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06473-2934
Mailing Address - Country:US
Mailing Address - Phone:203-281-1212
Mailing Address - Fax:203-281-2746
Practice Address - Street 1:27 PRIMROSE ST
Practice Address - Street 2:
Practice Address - City:NORTH HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06473-2934
Practice Address - Country:US
Practice Address - Phone:203-281-1212
Practice Address - Fax:203-281-2746
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-20
Last Update Date:2009-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
No231HA2400XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology PractitionerGroup - Single Specialty
No231HA2500XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology SupplierGroup - Single Specialty
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTC02952Medicare UPIN