Provider Demographics
NPI:1922092683
Name:ARICK, JUDITH (AUD CCC A)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:
Last Name:ARICK
Suffix:
Gender:F
Credentials:AUD CCC A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1842 BEACON ST
Mailing Address - Street 2:SUITE #403
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02445
Mailing Address - Country:US
Mailing Address - Phone:617-232-1299
Mailing Address - Fax:617-232-7959
Practice Address - Street 1:1842 BEACON ST
Practice Address - Street 2:SUITE #403
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02445
Practice Address - Country:US
Practice Address - Phone:617-232-1299
Practice Address - Fax:617-232-7959
Is Sole Proprietor?:No
Enumeration Date:2005-09-08
Last Update Date:2007-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAAS0119OtherBC/BS
MAAA439OtherHPHC
MA001764Medicare ID - Type Unspecified