1386834208 NPI number — AUDIOLOGY & HEARING AID ASSOCIATES LLC

Table of content: (NPI 1386834208)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386834208 NPI number — AUDIOLOGY & HEARING AID ASSOCIATES LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AUDIOLOGY & HEARING AID ASSOCIATES LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1386834208
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/28/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 46
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MORRISVILLE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19067-0046
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-295-7126
Provider Business Mailing Address Fax Number:
215-295-1403

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
900 W TRENTON AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MORRISVILLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19067-3571
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-295-7126
Provider Business Practice Location Address Fax Number:
215-295-1403
Provider Enumeration Date:
07/26/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
BUTERA
Authorized Official First Name:
JUDITH
Authorized Official Middle Name:
CANO
Authorized Official Title or Position:
SOLE MEMBER
Authorized Official Telephone Number:
215-295-7126

Provider Taxonomy Codes

  • Taxonomy code: 231H00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 237700000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2835310000 . This is a "INDEPENDENCE BLUE CROSS B" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".