Provider Demographics
NPI:1356536296
Name:HBC MARTY LAYNE ASSOCIATES, LLC
Entity type:Organization
Organization Name:HBC MARTY LAYNE ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:A
Authorized Official - Last Name:LAYNE
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:207-883-6466
Mailing Address - Street 1:23 SPRING ST
Mailing Address - Street 2:SUITE D
Mailing Address - City:SCARBOROUGH
Mailing Address - State:ME
Mailing Address - Zip Code:04074-7701
Mailing Address - Country:US
Mailing Address - Phone:207-883-6466
Mailing Address - Fax:207-883-6556
Practice Address - Street 1:23 SPRING ST
Practice Address - Street 2:SUITE D
Practice Address - City:SCARBOROUGH
Practice Address - State:ME
Practice Address - Zip Code:04074-7701
Practice Address - Country:US
Practice Address - Phone:207-883-6466
Practice Address - Fax:207-883-6556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-13
Last Update Date:2013-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME0002603Medicare PIN
MEDG3629Medicare PIN