Provider Demographics
NPI:1912259193
Name:BRISTOL HEARING AIDS, LLC
Entity Type:Organization
Organization Name:BRISTOL HEARING AIDS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JOANNE
Authorized Official - Middle Name:E
Authorized Official - Last Name:CYR-CALLAGHAN
Authorized Official - Suffix:
Authorized Official - Credentials:BC-HIS
Authorized Official - Phone:860-506-3720
Mailing Address - Street 1:72 PINE ST
Mailing Address - Street 2:UNIT B
Mailing Address - City:BRISTOL
Mailing Address - State:CT
Mailing Address - Zip Code:06010-6960
Mailing Address - Country:US
Mailing Address - Phone:860-506-3720
Mailing Address - Fax:860-506-3721
Practice Address - Street 1:72 PINE ST
Practice Address - Street 2:UNIT B
Practice Address - City:BRISTOL
Practice Address - State:CT
Practice Address - Zip Code:06010-6960
Practice Address - Country:US
Practice Address - Phone:860-506-3720
Practice Address - Fax:860-506-3721
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-11
Last Update Date:2012-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000198237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Multi-Specialty