Provider Demographics
NPI:1689193484
Name:CLEAR CHOICE HEARING LLC
Entity Type:Organization
Organization Name:CLEAR CHOICE HEARING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:CANCELLIERI
Authorized Official - Suffix:
Authorized Official - Credentials:BC-HIS
Authorized Official - Phone:603-321-4826
Mailing Address - Street 1:52 MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:NH
Mailing Address - Zip Code:03033-2491
Mailing Address - Country:US
Mailing Address - Phone:603-321-4826
Mailing Address - Fax:
Practice Address - Street 1:90 AIRPORT RD STE 29
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-5326
Practice Address - Country:US
Practice Address - Phone:800-717-5004
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-12
Last Update Date:2017-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHH518261QH0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech