Provider Demographics
NPI:1285759928
Name:COUNTY HEARING AND BALANCE, INC.
Entity type:Organization
Organization Name:COUNTY HEARING AND BALANCE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:W
Authorized Official - Last Name:WORGUL
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:860-443-6944
Mailing Address - Street 1:167 PARKWAY N
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06385-1200
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:167 PARKWAY N
Practice Address - Street 2:
Practice Address - City:WATERFORD
Practice Address - State:CT
Practice Address - Zip Code:06385-1200
Practice Address - Country:US
Practice Address - Phone:860-443-6944
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTC02107Medicare ID - Type UnspecifiedGROUP NUMBER
CTC02106Medicare ID - Type UnspecifiedGROUP NUMBER