Provider Demographics
NPI:1659072221
Name:COASTAL HEARING AIDS OF CONNECTICUT LLC
Entity Type:Organization
Organization Name:COASTAL HEARING AIDS OF CONNECTICUT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MS
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:
Authorized Official - Last Name:COOKE
Authorized Official - Suffix:
Authorized Official - Credentials:HIS
Authorized Official - Phone:475-231-1010
Mailing Address - Street 1:388 MAIN ST STE 1A
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:CT
Mailing Address - Zip Code:06468-1150
Mailing Address - Country:US
Mailing Address - Phone:475-231-1010
Mailing Address - Fax:
Practice Address - Street 1:388 MAIN ST STE 1A
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:CT
Practice Address - Zip Code:06468-1150
Practice Address - Country:US
Practice Address - Phone:475-231-1010
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-13
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty