Organization
GREATER PORTLAND HEARING PC
Active
Organization
GREATER PORTLAND HEARING PC
Active
Other names
Yarmouth Audiology
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KRISTIE A IACUESSA AU.D. (OWNER, AUDIOLOGIST)
(207) 846-1380
Entity
Organization
Contact information
Practice address
163 MAIN ST, YARMOUTH, ME 04096-6720
(207) 846-1380
(207) 846-9701
Mailing address
163 MAIN ST, YARMOUTH, ME 04096-6720
(207) 846-1380
(207) 846-9701
Taxonomy
Speciality
Code
Description
License number
State
237600000X
Audiologist-Hearing Aid Fitter
Primary
AP1251
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1063586907
NPI
ME
05
—
274460099
—
ME
Enumeration date
10/08/2012
Last updated
10/08/2012
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