Basic Information
| Provider Information | |||||||||
| NPI: | 1508923038 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FRAZER | ||||||||
| FirstName: | SYLVIA | ||||||||
| MiddleName: | D. | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | M.S., CCC-A | ||||||||
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| Mailing Information | |||||||||
| Address1: | 243 CHARLES ST | ||||||||
| Address2: | AUDIOLOGY DEPARTMENT | ||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021143002 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6175733266 | ||||||||
| FaxNumber: | 6175733023 | ||||||||
| Practice Location | |||||||||
| Address1: | 243 CHARLES ST | ||||||||
| Address2: | AUDIOLOGY DEPARTMENT | ||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021143002 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6175733266 | ||||||||
| FaxNumber: | 6175733023 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/03/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 231H00000X | 79 | MA | Y | Speech, Language and Hearing Service Providers | Audiologist |
ID Information
| ID | Type | State | Issuer | Description | AD0114 | 01 | MA | BLUE CROSS PROVIDER | OTHER |