Provider Demographics
NPI:1578080354
Name:BOSTON AUDIOLOGY CONSULTANTS, INC
Entity Type:Organization
Organization Name:BOSTON AUDIOLOGY CONSULTANTS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:FLIGOR
Authorized Official - Suffix:
Authorized Official - Credentials:SCD
Authorized Official - Phone:617-290-6821
Mailing Address - Street 1:26 MAYFLOWER DR
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:02048-3084
Mailing Address - Country:US
Mailing Address - Phone:617-290-6821
Mailing Address - Fax:
Practice Address - Street 1:26 MAYFLOWER DR
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:MA
Practice Address - Zip Code:02048-3084
Practice Address - Country:US
Practice Address - Phone:617-290-6821
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-23
Last Update Date:2018-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA739231H00000X, 237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Multi-Specialty