| Organization Name: | GREATER PORTLAND HEARING PC |
| NPI Number: | 1194077602 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KRISTIE A IACUESSA (OWNER, AUDIOLOGIST) |
| Mailing Address: | 163 Main St Yarmouth |
| State: | ME US |
| Postal Code: | 040966720 |
| Phone Number: | 2078461380 |
| Fax Number: | 2078469701 |
| NPI Enumeration Date: | 10/08/2012 |
| NPI Last Update Date: | 10/08/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 237600000X |
| License Number: | AP1251 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ME |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Audiologist-Hearing Aid Fitter |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An audiologist/hearing aid fitter is the professional who specializes in evaluating and treating people with hearing loss, conducts a wide variety of tests to determine the exact nature of an individual |