Provider Demographics
NPI:1649333584
Name:AA HEARING AID CENTER,INC.
Entity type:Organization
Organization Name:AA HEARING AID CENTER,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER AUDIOLOGIST
Authorized Official - Prefix:MR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:G
Authorized Official - Last Name:OGILVY
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:203-374-8900
Mailing Address - Street 1:4270 MAIN STREET
Mailing Address - Street 2:AA HEARING AID CENTER
Mailing Address - City:BRIDGEPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06606-2306
Mailing Address - Country:US
Mailing Address - Phone:203-374-8900
Mailing Address - Fax:
Practice Address - Street 1:4270 MAIN STREET
Practice Address - Street 2:AA HEARING AID CENTER
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06606-2306
Practice Address - Country:US
Practice Address - Phone:203-374-8900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-19
Last Update Date:2009-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000236237600000X
CT000211AUDIOLOGY231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004014494Medicaid