Provider Demographics
NPI:1851822993
Name:HOPKINTON AUDIOLOGY LLC
Entity Type:Organization
Organization Name:HOPKINTON AUDIOLOGY LLC
Other - Org Name:BAYSTATE AUDIOLOGY LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:AUDIOLOGIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DARCY
Authorized Official - Middle Name:
Authorized Official - Last Name:REPUCCI
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-A
Authorized Official - Phone:508-936-3277
Mailing Address - Street 1:1 LUMBER ST. STE 207A
Mailing Address - Street 2:
Mailing Address - City:HOPKINTON
Mailing Address - State:MA
Mailing Address - Zip Code:01748
Mailing Address - Country:US
Mailing Address - Phone:508-936-3277
Mailing Address - Fax:
Practice Address - Street 1:1 LUMBER ST. STE 207A
Practice Address - Street 2:
Practice Address - City:HOPKINTON
Practice Address - State:MA
Practice Address - Zip Code:01748
Practice Address - Country:US
Practice Address - Phone:508-936-3277
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-21
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
231H00000X
MA872261QH0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
No261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and SpeechGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110119703/AMedicaid
MA11019703AMedicaid