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Individual

MR. KENNETH CHARLES PRUYN JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
67 FOREST ST STE 350-25, MARLBOROUGH, MA 01752-3195
(508) 794-3620
(508) 205-0291
Mailing address
20 BEAVER POND RD STE 201, MILFORD, MA 01757-3743
(508) 794-3620
(508) 205-0291

Taxonomy

Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
254
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1538136
MA
01
316454
BLUECROSS
MA
Enumeration date
11/06/2007
Last updated
10/10/2025
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