Provider Demographics
NPI:1558629626
Name:COMMUNITY HEARING AIDS OF CT LLC
Entity Type:Organization
Organization Name:COMMUNITY HEARING AIDS OF CT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KIMBALLI
Authorized Official - Middle Name:P
Authorized Official - Last Name:STARTZ
Authorized Official - Suffix:
Authorized Official - Credentials:HIS
Authorized Official - Phone:860-326-5518
Mailing Address - Street 1:441 LONG HILL RD
Mailing Address - Street 2:
Mailing Address - City:GROTON
Mailing Address - State:CT
Mailing Address - Zip Code:06340-4149
Mailing Address - Country:US
Mailing Address - Phone:860-326-5518
Mailing Address - Fax:860-326-5723
Practice Address - Street 1:441 LONG HILL RD
Practice Address - Street 2:
Practice Address - City:GROTON
Practice Address - State:CT
Practice Address - Zip Code:06340-4149
Practice Address - Country:US
Practice Address - Phone:860-326-5518
Practice Address - Fax:860-326-5723
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-26
Last Update Date:2012-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000322237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Multi-Specialty