Provider Demographics
NPI:1093847071
Name:HEALEY, JAMES EDWARD (AUD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:EDWARD
Last Name:HEALEY
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 STRATHMORE RD
Mailing Address - Street 2:
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02905-3723
Mailing Address - Country:US
Mailing Address - Phone:401-461-3965
Mailing Address - Fax:401-461-3965
Practice Address - Street 1:200 TOLL GATE RD
Practice Address - Street 2:SUITE 203
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-4440
Practice Address - Country:US
Practice Address - Phone:401-461-3965
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI63231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI402407OtherBLUE CHIP
RI2420-2OtherBLUE CROSS BLUE SHIELD
RI4500028OtherUNITED HEALTH CARE
RI649002420Medicare UPIN
RI4500028OtherUNITED HEALTH CARE