Provider Demographics
NPI:1942636485
Name:HARBORSIDE HEARING CARE CENTERS, INC
Entity Type:Organization
Organization Name:HARBORSIDE HEARING CARE CENTERS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DARLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:PEKENIA
Authorized Official - Suffix:
Authorized Official - Credentials:HIS
Authorized Official - Phone:508-524-4783
Mailing Address - Street 1:1421 ORLEANS ROAD
Mailing Address - Street 2:
Mailing Address - City:HARWICH
Mailing Address - State:MA
Mailing Address - Zip Code:02645
Mailing Address - Country:US
Mailing Address - Phone:508-432-1222
Mailing Address - Fax:508-430-8686
Practice Address - Street 1:1421 ORLEANS ROAD
Practice Address - Street 2:
Practice Address - City:HARWICH
Practice Address - State:MA
Practice Address - Zip Code:02645
Practice Address - Country:US
Practice Address - Phone:508-432-1222
Practice Address - Fax:508-430-8686
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-16
Last Update Date:2013-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAHIS#49237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty