Provider Demographics
NPI:1982892485
Name:ADVANCED HEARING HEALTHCARE CENTERS INC
Entity Type:Organization
Organization Name:ADVANCED HEARING HEALTHCARE CENTERS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:DIRIENZO
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:860-944-9938
Mailing Address - Street 1:340 BROAD ST STE 100
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:CT
Mailing Address - Zip Code:06095-3030
Mailing Address - Country:US
Mailing Address - Phone:860-688-8887
Mailing Address - Fax:860-687-1744
Practice Address - Street 1:340 BROAD ST
Practice Address - Street 2:UNIT 102
Practice Address - City:WINDSOR
Practice Address - State:CT
Practice Address - Zip Code:06095-3030
Practice Address - Country:US
Practice Address - Phone:860-688-8887
Practice Address - Fax:860-687-1744
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-09
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000457332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004260204Medicaid