Provider Demographics
NPI:1912107723
Name:COMPREHENSIVE HEARING CARE CENTER, LLC
Entity Type:Organization
Organization Name:COMPREHENSIVE HEARING CARE CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGIST, OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:ORRILL
Authorized Official - Last Name:SHEA
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:203-272-4512
Mailing Address - Street 1:415 HIGHLAND AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:CHESHIRE
Mailing Address - State:CT
Mailing Address - Zip Code:06410-2555
Mailing Address - Country:US
Mailing Address - Phone:203-272-4512
Mailing Address - Fax:203-272-4517
Practice Address - Street 1:415 HIGHLAND AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:CHESHIRE
Practice Address - State:CT
Practice Address - Zip Code:06410-2555
Practice Address - Country:US
Practice Address - Phone:203-272-4512
Practice Address - Fax:203-272-4517
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-19
Last Update Date:2012-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Multi-Specialty
No332S00000XSuppliersHearing Aid EquipmentGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT3272905OtherAETNA
CTP2928474OtherOXFORD
CT004070637Medicaid
CT004236734Medicaid
CT152000OtherCONNECTICARE
CT730000152CT03OtherANTHEM - AUDIOLOGY
CT0121288OtherCIGNA
CT2V6948OtherHEALTHNET
CT660000707CT02OtherANTHEM - SPEECH PATHOLOGY
CT660000707CT02OtherANTHEM - SPEECH PATHOLOGY