Provider Demographics
NPI:1154531614
Name:PUTTICK, ANDREW JOSEPH (MA, CCC-A, FAAA)
Entity type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:JOSEPH
Last Name:PUTTICK
Suffix:
Gender:M
Credentials:MA, CCC-A, FAAA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:93 DARTMOUTH ST
Mailing Address - Street 2:
Mailing Address - City:HOLYOKE
Mailing Address - State:MA
Mailing Address - Zip Code:01040-2001
Mailing Address - Country:US
Mailing Address - Phone:413-535-1559
Mailing Address - Fax:413-442-9701
Practice Address - Street 1:510 NORTH STREET
Practice Address - Street 2:GREYLOCK EAR, NOSE AND THROAT ASSOCIATES
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201
Practice Address - Country:US
Practice Address - Phone:413-443-4800
Practice Address - Fax:413-442-9701
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA784231HA2400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231HA2400XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Practitioner