Provider Demographics
NPI:1679500367
Name:MOBILE AUDIOLOGY ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:MOBILE AUDIOLOGY ASSOCIATES, P.C.
Other - Org Name:HEALTHDRIVE AUDIOLOGY GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:L
Authorized Official - Last Name:TASSE
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:617-964-6681
Mailing Address - Street 1:100 CROSSING BLVD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01702-5555
Mailing Address - Country:US
Mailing Address - Phone:617-964-6681
Mailing Address - Fax:339-686-2561
Practice Address - Street 1:12 PENNS TRAIL
Practice Address - Street 2:SUITE 154
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-3438
Practice Address - Country:US
Practice Address - Phone:215-675-3005
Practice Address - Fax:888-662-0859
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MOBILE AUDIOLOGY ASSOCIATES, P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-27
Last Update Date:2019-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAHE1676342OtherBLUE CROSS BLUE SHIELD
PACE9855OtherMEDICARE RAILROAD
PAHE1676342OtherBLUE CROSS BLUE SHIELD