1497985253 NPI number — CLEAR CHOICE HEARING SOLUTIONS, INC

Table of content: (NPI 1497985253)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497985253 NPI number — CLEAR CHOICE HEARING SOLUTIONS, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CLEAR CHOICE HEARING SOLUTIONS, INC
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:
CLEAR CHOICE HEARING & BALANCE
Provider Other Organization Name Type Code:
3
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:
1497985253
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/16/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
103 CANAL LANDING BLVD
Provider Second Line Business Mailing Address:
SUITE 3
Provider Business Mailing Address City Name:
ROCHESTER
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
14626-5108
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
585-723-3440
Provider Business Mailing Address Fax Number:
585-486-1052

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
103 CANAL LANDING BLVD
Provider Second Line Business Practice Location Address:
SUITE NUMBER 3
Provider Business Practice Location Address City Name:
ROCHESTER
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14626-5108
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
585-723-3440
Provider Business Practice Location Address Fax Number:
585-486-1052
Provider Enumeration Date:
07/15/2009

Additional Information

Authorized Official

Authorized Official Last Name:
TIRK
Authorized Official First Name:
CHRISTINE
Authorized Official Middle Name:
M
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
585-723-3440

Provider Taxonomy Codes

  • Taxonomy code: 231H00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 237700000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 252Y00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1497985253 . This is a "ESSENCE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1497985253 . This is a "MVP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1497985253 . This is a "SIDNEY HILLMAN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1497985253 . This is a "AETNA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1497985253 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1497985253 . This is a "EMPIRE PLAN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1497985253 . This is a "ESCO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1497985253 . This is a "TRICARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1497985253 . This is a "WELLCARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1497985253 . This is a "NALC" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1497985253 . This is a "LOGISTICS HEALTH" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1497985253 . This is a "EXCELLUS-BLUE CHOICE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1497985253 . This is a "HUMANA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1497985253 . This is a "EXCELLUS BC/BS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1497985253 . This is a "CIGNA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1497985253 . This is a "MONROE PLAN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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