Provider Demographics
NPI:1952335895
Name:HAMPDEN HEARING SERVICES, INC.
Entity Type:Organization
Organization Name:HAMPDEN HEARING SERVICES, INC.
Other - Org Name:HAMPDEN HEARING CENTER EAST
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:BANKOSKI
Authorized Official - Last Name:CHUNYK
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:413-525-7979
Mailing Address - Street 1:200 N MAIN ST
Mailing Address - Street 2:NORTH BUILDING, SUITE 103
Mailing Address - City:EAST LONGMEADOW
Mailing Address - State:MA
Mailing Address - Zip Code:01028-2392
Mailing Address - Country:US
Mailing Address - Phone:413-525-7979
Mailing Address - Fax:413-525-8303
Practice Address - Street 1:200 N MAIN ST
Practice Address - Street 2:NORTH BUILDING, SUITE 103
Practice Address - City:EAST LONGMEADOW
Practice Address - State:MA
Practice Address - Zip Code:01028-2392
Practice Address - Country:US
Practice Address - Phone:413-525-7979
Practice Address - Fax:413-525-8303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA265231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAAG0006OtherBC/BS GROUP NUMBER
MA000000020602OtherBMC HEALTHNET GROUP NMBR
MA9712950Medicaid
MAAG0006OtherBC/BS GROUP NUMBER