Provider Demographics
NPI:1306077276
Name:MASS AUDIOLOGY, LLC
Entity type:Organization
Organization Name:MASS AUDIOLOGY, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:V.P. ACCOUNTING
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVE
Authorized Official - Middle Name:
Authorized Official - Last Name:DUTSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-564-7115
Mailing Address - Street 1:2501 COTTONTAIL LN
Mailing Address - Street 2:STE 101
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-5125
Mailing Address - Country:US
Mailing Address - Phone:732-529-7151
Mailing Address - Fax:732-568-7742
Practice Address - Street 1:2501 COTTONTAIL LN
Practice Address - Street 2:STE 101
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-5125
Practice Address - Country:US
Practice Address - Phone:732-529-7151
Practice Address - Fax:732-568-7742
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-27
Last Update Date:2014-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and SpeechGroup - Single Specialty