Provider Demographics
NPI:1821425919
Name:HEARING CENTER OF SOUTHERN CONNECTICUT LLC
Entity Type:Organization
Organization Name:HEARING CENTER OF SOUTHERN CONNECTICUT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:SUGATA
Authorized Official - Middle Name:
Authorized Official - Last Name:BHATTACHARJEE
Authorized Official - Suffix:
Authorized Official - Credentials:AUD, CCC-A, FAAA
Authorized Official - Phone:203-752-7590
Mailing Address - Street 1:1 LONG WHARF DR
Mailing Address - Street 2:SUITE 302
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06511-5991
Mailing Address - Country:US
Mailing Address - Phone:203-752-7590
Mailing Address - Fax:203-777-8469
Practice Address - Street 1:1 LONG WHARF DR
Practice Address - Street 2:SUITE 302
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-5991
Practice Address - Country:US
Practice Address - Phone:203-752-7590
Practice Address - Fax:203-777-8469
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-03
Last Update Date:2013-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000468332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment