1053340729 NPI number — A & A MARYLAND HEARING CENTER, INC

Table of content: (NPI 1053340729)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1053340729 NPI number — A & A MARYLAND HEARING CENTER, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
A & A MARYLAND HEARING CENTER, 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:
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:
1053340729
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
19110 MONTGOMERY VILLAGE AVE
Provider Second Line Business Mailing Address:
SUITE 120
Provider Business Mailing Address City Name:
GAITHERSBURG
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20886-3702
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-977-6317
Provider Business Mailing Address Fax Number:
301-977-8504

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
19110 MONTGOMERY VILLAGE AVE
Provider Second Line Business Practice Location Address:
SUITE 120
Provider Business Practice Location Address City Name:
GAITHERSBURG
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20886-3702
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-977-6317
Provider Business Practice Location Address Fax Number:
301-977-8504
Provider Enumeration Date:
07/03/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SORENSEN
Authorized Official First Name:
SHARON
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
301-977-6317

Provider Taxonomy Codes

  • Taxonomy code: 231H00000X , with the licence number:  00392 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 64003264 . This is a "MEDICARE RAILROAD" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 801591 . This is a "JOHN HOPKINS HEALTH" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 3460132 . This is a "AETNA HMO" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: LO98SW . This is a "CAREFIRST MARYLAND XW,XIP" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 1320 . This is a "CAREFIRST FEDERAL EMPLOYE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 8608484 . This is a "CIGNA" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 5309254 . This is a "AETNA PPO" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 9419833 . This is a "PHCS" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 221808 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




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