Provider Demographics
NPI:1982244455
Name:VERGE, JAMES E (BC-HIS)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:E
Last Name:VERGE
Suffix:
Gender:M
Credentials:BC-HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:62 BAILEY RD
Mailing Address - Street 2:
Mailing Address - City:MOOSUP
Mailing Address - State:CT
Mailing Address - Zip Code:06354-2500
Mailing Address - Country:US
Mailing Address - Phone:860-576-3482
Mailing Address - Fax:
Practice Address - Street 1:19 QUINEBAUG AVE
Practice Address - Street 2:
Practice Address - City:PUTNAM
Practice Address - State:CT
Practice Address - Zip Code:06260-1943
Practice Address - Country:US
Practice Address - Phone:860-315-9656
Practice Address - Fax:860-315-9635
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-13
Last Update Date:2020-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist