Provider Demographics
NPI:1912192485
Name:HEARING HEALTHCARE ASSOCIATES
Entity Type:Organization
Organization Name:HEARING HEALTHCARE ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WALTER
Authorized Official - Middle Name:CARY
Authorized Official - Last Name:LETIEN
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:978-922-1888
Mailing Address - Street 1:266 CABOT ST
Mailing Address - Street 2:P.O. BOX 488
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915-3370
Mailing Address - Country:US
Mailing Address - Phone:978-922-1888
Mailing Address - Fax:
Practice Address - Street 1:266 CABOT ST
Practice Address - Street 2:
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-3370
Practice Address - Country:US
Practice Address - Phone:978-922-1888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-07
Last Update Date:2007-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA123237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9774726Medicaid