Provider Demographics
NPI:1922142900
Name:ROSEANN Z GEORGE
Entity Type:Organization
Organization Name:ROSEANN Z GEORGE
Other - Org Name:PROFESSIONAL HEARING & SPEECH AID SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROSEANN
Authorized Official - Middle Name:ZIMMERMAN
Authorized Official - Last Name:GEORGE BURR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-859-2807
Mailing Address - Street 1:20 HARTFORD RD
Mailing Address - Street 2:SUITE 30
Mailing Address - City:SALEM
Mailing Address - State:CT
Mailing Address - Zip Code:06420-3800
Mailing Address - Country:US
Mailing Address - Phone:860-859-2807
Mailing Address - Fax:860-859-3102
Practice Address - Street 1:20 HARTFORD RD
Practice Address - Street 2:SUITE 30
Practice Address - City:SALEM
Practice Address - State:CT
Practice Address - Zip Code:06420-3800
Practice Address - Country:US
Practice Address - Phone:860-859-2807
Practice Address - Fax:860-859-3102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-16
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
0911785OtherAETNA
NH30761382Medicaid
MA1528092Medicaid
CT004014486Medicaid
702760OtherHARVARD PILGRIM HEALTHCAR
0460610001Medicare ID - Type Unspecified