Individual
AMY RENA FISTEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
25 NEEDHAM ST, NEWTON, MA 02461-1615
(617) 964-6681
(617) 630-0141
Mailing address
25 NEEDHAM ST, NEWTON, MA 02461-1615
(617) 964-6681
(617) 630-0141
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
72
MA
231H00000X
Audiologist
AUD00112
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
29016-4/411655
BLUE CROSS BLUE SHIELD
RI
05
—
5102154
—
MA
01
—
AD0149
BLUE CROSS BLUE SHIELD
MA
Enumeration date
07/29/2006
Last updated
07/08/2007
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